NCQA extends medical home model to specialists

The National Committee for Quality Assurance (NCQA) extended concepts of the patient-centered medical home by launching an evaluation program for specialists outside of primary care: NCQA Patient-Centered Specialty Practice (PSCP) Recognition.

The program is modeled on NCQA’s Patient-Centered Medical Home Recognition program, the most widely adopted medical home model in the U.S. Under PCSP, specialty practices committed to improving access, communication and care coordination serve as “neighbors” that inform the medical home and colleagues in primary care.

“NCQA’s Patient-Centered Specialty Practice Recognition is an important step forward. I sincerely hope the specialty community embraces it, just as the primary care world has embraced the patient-centered medical home,” said Ed Wagner, MD, MPH, creator of the Chronic Care Model.

The PCSP program recognizes specialty practices that:

• Establish agreements with primary care clinicians to exchange key information and establish coordinated care planning and management.
• Provide timely access to care and clinical advice based on patient need.
• Use a systematic approach to identify and track patients and coordinate care.
• Include the patient and family or caregiver (if appropriate in planning and managing care).
• Work with a delivery/reimbursement model that focuses on outcomes and reduced duplication of services.
• Align with newly proposed physician delivery and payment models (e.g., accountable care organizations, episodes of care, bundled payments).

The PCSP program is aligned with the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Program’s Meaningful Use criteria in recognition of the importance of health IT as a tool for coordinating information and clinical care. NCQA will use Stage 1 criteria to evaluate practices until January 1, 2015.

NCQA offers three levels of PCSP recognition. Level 1 represents a practice that meets the minimum score of 25 points (out of 100) and meets the mandatory elements. Practices earning additional points can qualify for higher levels of recognition, allowing growth within the PCSP program over time.

The standards for the new program are available for free here.