Payer Support: Partners in Quality
Because NCQA PCMH Recognition is associated with lower costs and better quality, many payers offer incentives, support or physician tiering to support practices that earn NCQA PCMH Recognition.
The NCQA Partners in Quality (PIQ) program recognizes organizations that provide financial incentives or support services to practices seeking recognition through one or more of these NCQA programs:
- Patient-Centered Medical Home Recognition.
- Patient-Centered Specialty Practice Recognition.
- Patient-Centered Connected Care Recognition.
- Oncology Medical Home Recognition.
- Heart and Stroke Recognition Program.
- Diabetes Recognition Program.
- Accountable Care Organization Accreditation.
- School-Based Medical Home Recognition.
Benefits of Becoming A Partner In Quality
- Demonstrate your commitment to quality improvement and the patient-centered model of care.
- Receive a discount code for NCQA Recognition for practices with which you work.
Partner in Quality Organization Eligibility
To earn NCQA Partner in Quality status, an organization must demonstrate that it provides qualifying financial incentives or support services to practices seeking NCQA recognition, at no cost to the practice.
Qualifying services should lead practices to apply for NCQA Recognition within a reasonable period of time, and include, but are not limited to:
- Cover the cost of NCQA application fees.
- Lump-sum payment for recognition.
- Include NCQA Recognition in enhanced payment structure (health plans only); for example:
- Enhanced fee-for-service.
- Care management fees.
- Shared savings.
Nonfinancial, In-Kind Assistance
- Self-assessment/gap analysis tools/support.
- Learning collaborative support.
- Onsite training/technical assistance.
- Care management support.
- “Preferred provider” status or recognition in member-facing directories (health plans only).
NCQA may allow other qualified support, as agreed on by NCQA and the Partner in Quality organization.
Organizations that qualify with support services only (not offering a financial incentive) must demonstrate that the provided support services are comprehensive enough to support a practice through the transformation process.
Find a Partner in Quality
NCQA maintains a directory of payer incentives and Partners in Quality.
How to Apply
To learn more about the NCQA Partners in Quality program, contact us through My NCQA and we will be in touch.
Business Considerations for PCMH
NCQA PCMH Recognition has been shown to improve quality and reduce health care costs. Practices that implement the PCMH model also need to effectively plan for how the implementation impacts them financially. NCQA engaged Milliman, the world’s largest providers of actuarial services to develop a white paper that addresses the question: What are the operational and financial considerations for becoming a PCMH-Recognized entity from the perspective of a primary care practice? Get the White Paper.