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Overview: Redesign of the PCSP and Oncology Medical Home Recognition Programs

About The Re-Design

On October 28, 2019, NCQA will launch a redesigned PCSP and Oncology Medical Home Recognition processes. The redesigned program includes ongoing, sustained recognition status with Annual Reporting instead of a 3-year recognition cycle. NCQA based the redesign on feedback from practices, policy makers, payers and other stakeholders. The program is more manageable, while continuing to concentrate on performance and quality improvement. It also reduces paperwork and increases practice interaction with NCQA.

The redesigned process offers:

  • Flexibility. Practices take the path to recognition that suits their strengths, schedule and goals.
  • Personalized service. Practices have more interaction with NCQA and are assigned an NCQA representative who works with them throughout the recognition process as a consistent point of contact.
  • User-friendly approach. Requirements remain meaningful, but with simplified reporting and less paperwork.
  • Continuous improvement. Annual Reporting helps practices strengthen as PCSPs. By reviewing your progress more often, you keep performance improvement at the top of your priorities list.
  • Alignment with changes in health care. The program aligns with current public and private initiatives and can adapt to future changes.

How Does It work?

The NCQA Recognition process has three parts.

  • Commit: The practice learns the NCQA concepts and begins to apply them to their practice. Once the practice is knowledgeable of the concepts and has begun transforming, they enroll through the NCQA Q-PASS system at qpass.ncqa.org.
  • Transform: Practices transform over time, building on successes. Along the way, NCQA conducts virtual reviews with the practice to gauge progress and to discuss next steps in the evaluation. Virtual reviews, which are conducted online via screen sharing technology, provide practices with immediate and personalized feedback on what is going well and what needs to improve.
  • Succeed: Each year, the practice shows how its ongoing activities are consistent with the patient-centered model of care. This is part of the Annual Reporting process and includes attesting to certain policies and procedures and submission of some data. This process sustains the practice’s recognition and fosters continuous improvement. That means the practice succeeds in strengthening its transformation and, as a result, patient care. NCQA has the only national program that supports ongoing quality improvement in this way.

Program Requirements

NCQA’s PCSP and Oncology Recognition programs have evolved to feature a set of seven concepts that are vital to strong specialty care. Underlying these concepts are criteria (activities for which a practice must demonstrate adequate performance to obtain Recognition) developed from evidence-based guidelines and best practices.

The standards and guidelines document contains these Recognition program requirements and information your practice needs to demonstrate to NCQA that you meet criteria. Refer to the concepts and criteria within this document, available for free download from the NCQA store. In this publication you will find the criteria and what evidence is needed to submit to NCQA to earn recognition.

  • Concepts. There are seven concepts—the overarching themes of PCSP. To earn recognition, your practice must complete criteria in each concept area. If you are familiar with past iterations of NCQA PCSP Recognition, the concepts are equivalent to standards.
  • Criteria. Specific activities in which a practice engages to demonstrate that it meets recognition requirements. The practice must pass core criteria and a certain number of elective credits across any of the 7 concepts.
    • PCSP: 38 Core; 20 Elective Credits.
    • Oncology: 49 Core; 9 Elective Credits.
  • Competencies. Competencies categorize the criteria. Competencies do not offer credit.

Annual Reporting

Annual Reporting helps practices strengthen as medical homes by reviewing progress and encouraging performance improvement more frequently. Learn more about Annual Reporting.

Process for Practices not Currently Recognized

Learn more about the recognition process and recommended timing.

Information for Currently Recognized Practices

Are you a practice renewing your recognition after October 28, 2019? If so, find out more about your path to renewal:

FAQS

Here are some of the commonly asked questions about the PCSP Recognition Program redesign.

Questions?

You may have questions about what is best for your practice. You can submit any questions you have through My NCQA and an NCQA representative will get back to you promptly.

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