NCQA updates PCMH standards
The National Committee for Quality Assurance (NCQA) officially presented new patient-centered medical home (PCMH) standards during a March 10 briefing.
The release follows the publication of a Journal of the American Medical Association study that found that medical home pilots resulted in limited improvements in quality and did not translate into reductions in utilization of hospital, emergency department or ambulatory care services or total costs over three years.
NCQA’s PCMH Recognition program is the most widely adopted medical home model in the country. PCMH is the fastest growing delivery system innovation, encompassing about 35,000 clinicians at 6,800 sites, according to the briefing.
The following changes affecting the advantages and requirements of NCQA PCMH include:
- Alignment with Meaningful Use (MU) Stage 2—NCQA’s requirements continue to reflect MU requirements, but raise the bar to include expectations for MU Stage 2.
- Enhanced emphasis on team-based care—Revised standards emphasize collaboration with patients as part of the care team and establish team-based care as a “must-pass” criterion for NCQA Recognition.
- Care management focus on high-need populations—Practices must address socioeconomic drivers of health and poorly controlled or complex conditions, and focus on patients’ special needs referred from the “medical neighborhood” of practices that surround and inform the medical home.
- Alignment of quality improvement with the triple aim—Practices must show that they are working to improve patient experience, cost and clinical quality.
- Sustained transformation—Practices must show that they comply with NCQA standards over long periods.
- Integration of behavioral health—Practice must support patients’ behavioral health, including disclosing to patients a practice’s behavioral healthcare capabilities and collaborating with behavioral healthcare providers.
Read the full presentation here.