FAQ Directory

If the condition is acute care management, the plan may be simpler than for a patient with a complex, chronic condition. The plan of care would include current medications, tests, treatment, patient/family self-care and important information about the family. While not every referral would have the same level of detail, be prepared to show a referral example for a patient that does have a care plan with the expected details. 

PCMH 2017

No. Practices may not use the same immunization for two age groups, and must identify two different immunizations for this criterion.

PCMH 2017

Yes, unhealthy behaviors can be the result of parent behavior but ultimately, we're looking for the unhealthy behaviors demonstrated by the patient (child). Secondhand smoke may be a direct example of a parent’s behavior affecting the child’s health and poor oral hygiene may be a child’s unhealthy behavior, but could result from lack of parental oversight or health literacy.

PCMH 2017

Social determinants of health include things like poverty, food insecurity, poor housing quality or homelessness, unstable neighborhoods, and parental dysfunction (e.g., domestic violence, mental illness, etc.).

PCMH 2017

Pediatric practices may want to look into quality improvement projects offered by state AAP chapters and national AAP. The AAP QI Webpage lists a variety of opportunities: https://www.aap.org/en-us/professional-resources/quality-improvement/Pages/ActivityList.aspx

PCMH 2017

Practices must provide a documented process for staff to follow to ensure that demographic and clinical data are available for the specialist, and either a report/log or an example showing that the process is followed (e.g., a screen shot of available information and how the information is made available to the specialist). If external referrals are made, the practice must specify the process for sharing information with those providers, as well. 

PCMH 2017

No. Although effective preventive care can reduce future health care costs, preventive care measures address quality of care and are not utilization measures. Utilization measures address direct health care savings, in accordance with evidence-based guidelines.

PCMH 2017

No. Practices may use any patient experience survey that includes questions related to three of the four categories specified in the standards (access; communication; coordination; whole-person care, self-management support and comprehensiveness).

PCMH 2017

PCMH 2017

No. Comment sections or “free text” questions on a patient experience survey do not meet the requirement as a method of collecting qualitative feedback from patients and their families.

PCMH 2017

No. A measure looking to increase the number of patients who complete the satisfaction survey would not meet the requirement. Practice should look at improving an area identified using the patient experience data collected in QI 04.

PCMH 2017

NCQA does not specify a time period required for remeasurement, but it must be long enough for the practice to implement a performance improvement plan and to assess results.

PCMH 2017