eCQM Adoption in NCQA Patient-Centered Medical Home Practices

Part of maintaining Patient-Centered Medical Home Recognition is Annual Reporting: Practices submit data and documentation to NCQA and attest to their continued adherence to PCMH criteria. NCQA also surveys PCMH practices during Annual Reporting, to better understand trends in health care such as behavioral health integration, use of telehealth technology and community resources for social determinants of health.  

During the 2020 Annual Reporting year submission, we asked practices this question: 

Does your practice have the capability to submit electronic measures (using the QRDA III format) for clinical quality measures (at least 2 different measures), care coordination, health care costs, patient experience and tracking referrals? 

Responses give a glimpse into current eCQM use across a wide spectrum of primary care practices. Of the roughly 5,300 PCMH practices that responded, 60% reported that they can submit at least two different Electronic Clinical Quality Measures (eCQM), which include immunization measures, preventive care measures, chronic/acute care measures and behavioral health measures. About 32% said they can report measures related to care coordination and referral tracking. Fewer practices—around 18%—can submit eCQMs related to patient experience. 

While the uptake is encouraging, there’s a lot of room for growth: 40% of PCMH practices said that they don’t have the capability to submit eCQMs using the QRDA III format. And although a growing number of value-based contracts require it, barriers to implementation still exist. Most PCMH practices use certified EHRs that can produce eCQMs, but many may face challenges to accurate reporting of eCQMs (e.g., limited EHR configuration, lack of technical support, financing).  

Practices that pursue PCMH vary in size and organizational support, but all have made a commitment to both quality improvement processes and the technology needed to support the improvement cycle. And it may be that these practices are the forerunners and that more primary care practices will follow. 

· What do you think will be the biggest driver of eCQM adoption in primary care? 

· What are other measurement and quality improvement opportunities for primary care practices? 

Share your thoughts with us in the Community Forum.