Friday, April 18, 2014

NCQA Launches New PCMH Standards; Announces Deadline for 2011 PCMH Recognition

By Kathy McCoy, MBA | UpdatesInPediatrics.com Guest Blogger

The Patient-Centered Medical Home, a concept first introduced by the American Academy of Pediatrics (AAP) in 1967 but now adopted much more broadly, is developing as studies demonstrate the need for different requirements.

One of the recent changes includes new requirements issued by one of the leading accrediting bodies, the National Committee for Quality Assurance (NCQA), on March 24, 2014, for the 2014 PCMH recognition program. The new program is designed to:    
  • Align more closely with Meaningful Use Stage 2 requirements
  • Emphasize team-based care
  • Align quality improvement activities with the “triple aim” of improving the patient experience and population health and reducing per capita costs of health care
  • Put a care management focus on high need populations

If you were planning to apply for PCMH recognition under the NCQA 2011 version, you need to know that the last day to purchase the 2011 Survey tool is June 30, 2014, and the last day to submit the 2011 Survey Tool is March 31, 2015.

Even if you haven’t decided which version to use, you may want to purchase the 2011 Survey Tool before the deadline runs out on June 30, 2014, in order to maintain the flexibility of choosing which recognition program—2011 or 2014—you want to be recognized for.

New Standards

In announcing the new standards, NCQA said that “PCMH 2014 retains strengths of earlier NCQA standards, including alignment with contemporary federal requirements for ‘meaningful use’ of health information technology—now Meaningful Use Stage 2.”

Changes in the advantages and requirements of the new NCQA PCMH Recognition include:
      Integration of behavioral health –Practices are expected to collaborate with behavioral health care providers and to convey behavioral health care capabilities to patients.
      Care management focus on high-need populations – Practices are expected to address socioeconomic drivers of health and poorly controlled or complex conditions. Practices should also focus on the special needs of patients referred from the “medical neighborhood” of practices that surround and inform the medical home.
      Enhanced emphasis on team-based care – The new standards emphasize collaboration with patients as part of the care team and establish team-based care as a “must-pass” criterion for NCQA Recognition.
      Alignment of improvement efforts with the triple aim – Practices must show that they are working to improve across all three components of the triple aim: patient experience, cost and clinical quality.
      Sustained transformation – In keeping with the goal of continuous improvement, practices must show that they comply with NCQA standards over long periods.

Between March 24, 2014, and March 31, 2015, practices can submit either the PCMH 2011 Survey Tool or the new version’s survey tool. After March 31, 2015, only the new survey tool will be accepted. It is important to note that the most progressive software vendors may begin to support the new standard exclusively sometime later this year. We advise medical practices interested in PCMH to focus on using the 2014 standard beginning in the 4th quarter of 2014.
Whether you are submitting the 2011 Survey Tool or the PCMH 2014 survey tool, the best way to become recognized as an NCQA Medical Home is to use software that has been pre-validated and that is Meaningful Use Stage 2 certified.

PCMH Resources
·      Watch a free recorded webinar on The Patient-CenteredMedical Home: What You Need to Know
·      See a free infographicWhat is Patient-Centered Medical Home?
·      Download the PCMH 2014 standards free of charge via the NCQA website.
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Kathy McCoy, MBA, is Director, Content Marketing, for HealthFusion, a leading provider of EHR and practice management software. She can be reached at: kmccoy@HealthFusion.com.

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