Healthcare is constantly changing, and if physician practices want to remain successful, they must find a way to change with it. The National Committee of Quality Assurance (NCQA) is dedicated to going to where health is headed while helping transform the way care is delivered.
NCQA revamped the Patient-Centered Medical Home (PCMH) recognition to closely align with the many changes in healthcare. With payers looking to reward value and quality instead of volume, PCMH recognition is a way physician practices can earn reimbursements for the time spent coordinating more effective care.
March 2017, NCQA released the new PCMH recognition process. This process outlines a practices journey in 3 steps: Commit, Transform, and Succeed. Through a practice’s process to PCMH recognition, NCQA has a hands-on approach to helping your practice achieve its goals.
On the road to recognition, the NCQA will assist organizations by:
1. Commit
Your organization will:
- – Complete a gap analysis of current clinical practices and resources
- – Determine priorities and capabilities for transformation based on current clinical practices and resources
- – Work with an NCQA representative to develop an evaluation schedule, identify support and education for transformation
The NCQA will assist by:
- – Providing information and resources to help in the decision-making process to pursue transformation and NCQA recognition
- – Assign a representative from the NCQA as your primary point of contact.
- – Grant your practice access to an online self-assessment
- – Work with your organization to develop an evaluation schedule
2. Transform
Your organization will:
- – Implement necessary changes in order to transform into a PCMH
- – Participate in three online, virtual check-in sessions with an NCQA evaluator to submit documentation, confirm progress and accumulate credits toward recognition
- – Earn NCQA PCMH Recognition after demonstrating transformation
The NCQA will assist by:
- – Closely monitoring the practice’s transformation progress
- – Assigning an evaluator to conduct the recognition review
- – Conducting three virtual check-ins to determine whether your practice is transforming and meeting PCMH recognition requirements
- – Reviewing your practice’s final submission and forwards it to the NCQA Peer Review Committee for evaluation and confirmation of initial approval
3. Succeed
Your organization will:
- – Sustain PCMH activities and continue to evolve as a medical home and improve patient care
- – Perform an annual check-in with NCQA to verify continued success as a PCMH
- – Earn NCQA PCMH Recognition for the following year
The NCQA will assist by:
- – Conducting your annual check-in to confirm that your organization continues ongoing transformation activities
- – Evaluate your practice’s submitted data and documentation that demonstrate a continued transformation
- – Audit a random sample of practice submissions to verify that PCMH requirements and guidelines are being met over time
Like any process, transforming into a patient-centered medical home is not necessarily easy. It takes time, effort, and commitment. However, with assistance from the NCQA, your practice can achieve recognition and begin improving care for your patients.
For more information regarding the transformation to a patient-centered medical home, contact a CipherHealth team member today.
