FAQ Directory: Patient-Centered Medical Home (PCMH)

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6.14.2018 QI 01 (Pediatric Specific) Can a practice use the CHIPRA Initial Core Set of Children’s Health Care Quality Measures?

Yes. Measures from the CHIPRA Initial Core Set meet the requirements.

PCMH 2017

6.14.2018 QI 02B (Pediatric Specific) What are some examples of utilization measures appropriate for pediatric practices?

Emergency department visits for ambulatory-care sensitive conditions.

Re-admissions within 30 days.

Urgent care visits while the practice is open.

PCMH 2017

6.14.2018 KM 02F (Pediatric Specific) How do clinicians assess the pediatric patient's ability to interact with other kids in a normal fashion? If the child is functioning normally in school would that suffice?

A social-emotional screening tool would be the best route to assess this, and the recommendation is for that screening to be done on a regular basis.

PCMH 2017

6.14.2018 KM 24 (Pediatric Specific) • AAP resource:

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

PCMH 2017

6.14.2018 KM 02G (Pediatric Specific) What are some examples of social determinants of health for children?

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

6.14.2018 AC 12 (Pediatric Specific) • AAP practice transformation resources—telephone care:

6.14.2018 KM 12B (Pediatric Specific) Does a list of pediatric patients from two age groups (e.g., 2-year-olds and 6-year-olds) that are “behind” on immunizations meet the requirements of this criterion?

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

PCMH 2017

6.14.2018 KM 09 (Pediatric Specific) The examples provided in the guidance section for this criterion aren’t typical characteristics for pediatric practices (e.g. gender identify, sexual orientation, occupation, etc.). What other options can a pediatric population use for its third aspect of diversity?

Identifying children with Medicaid insurance would meet the intent of this criterion, as this identifies a population that could be at risk or require additional attention or care management. Other areas of diversity could include homelessness, immigrant status, living in a rural or urban environment, family employment status, family socioeconomic status, families with a single parent, etc. 

PCMH 2017

6.14.2018 AC 02 (Pediatric Specific) If a pediatric practice has extra appointments based on the season [in the summer for physicals (prior to school starting) and has extra appointments in the winter for sick appointments] does this meet the criterion?

No, just having extra appointments based on the season would not meet the intent. The practice may have more same day appointments offered during these high-volume time periods but some same day appointments should be provided daily throughout the year.

PCMH 2017

6.14.2018 CC 12 (Pediatric Specific) • AAP resource:

6.14.2018 AC 06 (Pediatric Specific)` If a pediatrician sees more than one child from the same family during one visit, does this meet the requirement for an alternative clinical encounter?

No. Shared appointments would not meet the requirement. Alternative appointments need to be offered through telephone or other technology-supported mechanisms.

PCMH 2017

6.14.2018 CM 01D (Pediatric Specific) May practices use “limited or no family/caregiver support” as a social determinant of health?

Yes. For pediatric populations, practices may identify children and youth with special health care needs who are defined by the U.S. Department of Health and Human Services Maternal and Child Health Bureau as children “who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who require health and related services of a type or amount beyond that required generally.” 

PCMH 2017