FAQs: Patient-Centered Medical Home Recognition Program
Here are some of the most frequently asked questions about the NCQA Patient-Centered Medical Home Recognition program. If you don’t see what you are looking for below, you can search NCQA’s database of additional common questions or ask a question through My NCQA.
What is Patient-Centered Medical Home Recognition?
The Patient-Centered Medical Home (PCMH) is a model of care that puts patients at the forefront of care. PCMHs build better relationships between patients and their clinical care teams. Research shows that PCMHs improve quality, the patient experience and staff satisfaction, while reducing health care costs. Practices that earn recognition show that they have made a commitment to providing quality improvement within their practice and a patient-centered approach to care.
How does PCMH Recognition help my organization?
NCQA PCMH Recognition can help you improve the quality of care provided and reduce health care costs. In addition, PCMHs lead to happier patients and staff, which has a positive effect on patient satisfaction scores. See published evidence about how PCMHs impact quality and cost here, or learn more about benefits to your practice and patients here.
What are the requirements for PCMH Recognition?
The PCMH standards and guidelines document contains PCMH recognition program requirements and information your practice needs to demonstrate to NCQA that you meet criteria. Refer to the PCMH concepts and criteria within this document, available for free download from the NCQA store. This document contains tables with criteria and information about evidence your practice must submit to NCQA. Learn more about the concept areas.
Where can I find the Standards and Guidelines?
The Standards & Guidelines document is the publication that contains the requirements for recognition. You can download this document for free through the NCQA Store.
What organizations are eligible for PCMH Recognition?
An eligible practice consists of one or more clinicians (including all eligible primary care clinicians) who practice together and provide primary patient care at a single geographic location. Clinicians who hold a current, unrestricted license as a doctor of medicine (MD), doctor of osteopathy (DO), APRN (including nurse practitioners, clinical nurse specialists) or a physician assistant (PAs) who practices internal medicine, family medicine or pediatrics, with the intention of serving as the personal clinician for their patients are eligible.
What is the process for earning PCMH Recognition?
To become an NCQA-Recognized PCMH, a primary care practice learns the NCQA PCMH concepts and required criteria and begins the transformation process. NCQA conducts online check-ins to gauge the practice’s progress and discuss the next steps in the evaluation. View the complete recognition process.
What is the price for PCMH Recognition?
Fees apply to each clinician associated with the practice’s recognition. NCQA PCMH Recognition pricing is based on a practice’s eligibility for single-site pricing or multi-site pricing, and on the number of clinicians in the practice. Single-site pricing is for organizations with fewer than 3 practice sites. Practices seeking recognition for the first time pay the recognition fee at enrollment. Thereafter, they pay the recognition fee during Annual Reporting. Full pricing information is located in the Standards and Guidelines document.
How long will it take to earn PCMH Recognition?
Since practices work at their own pace it varies, but typically it takes 9 to 12 months. You should enroll in Q-PASS approximately 6-9 months prior to the date by which you want to earn recognition.
What To Expect For Annual Reporting Audit?
If your practice is selected for annual reporting audit, view the Audit Process
How do I get started?
If your practice is not currently recognized and is interested in learning more about NCQA Recognition, contact NCQA. If your practice is currently recognized and want to talk to someone about its current status, renewing or adding recognitions, submit a question through My NCQA.
Are there any other documents or information that will help me get started?
Go to the Get Started section on the NCQA website for everything you need to move forward with the PCMH recognition process.
What other organizations have earned PCMH Recognition?
Approximately 13,000 primary care practices (with more than 67,000 clinicians) have been recognized as medical homes by NCQA. Find a directory of recognized organizations with the NCQA Report Card.