FAQ Directory

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.).

This applies to the following Programs and Years:

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. 

This applies to the following Programs and Years:

Practices need to identify behavioral health-related criteria pertinent to their specific patient population such as a behavioral health diagnosis, substance use, a positive screening result from a standardized behavioral health screen, or psychiatric hospitalizations. If the practice feels that patients with temper tantrums is an identifier for patients in need of care management, the practice can use that defining criteria.

This applies to the following Programs and Years:

 –https://www.aap.org/en-us/professional-resources/practice-support/Telephone-Care/Pages/Telephone-Care.aspx 

This applies to the following Programs and Years:

Practices can use two methods to collect language need information:

1. Collect data from all patients and their families to create a report showing language needs.

2. Obtain data from an external source (e.g., data about the local community or its patient population).

Patients who do not speak English and patients from racial/ethnic minority groups may be less inclined to provide this information. Care should be taken to request the information using methods that respect multi-cultural differences.

This applies to the following Programs and Years:

− Shared Decision-Making in Pediatrics: A National Perspective Pediatrics 2010;126;306: 
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3373306/ 

This applies to the following Programs and Years:

This applies to the following Programs and Years:

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. 

This applies to the following Programs and Years:

No, practices are not required to use an NCQA-Certified survey vendor.

This applies to the following Programs and Years:

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.

This applies to the following Programs and Years:

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.

This applies to the following Programs and Years:

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).

This applies to the following Programs and Years: