What is a Patient-Centered Medical Home?

Why Become an NCQA Recognized Patient-Centered Medical Home?

The National Committee for Quality Assurance (NCQA) has created a Patient-Centered Medical Home (PCMH) 2011 Recognition Program that emphasizes the systematic use of patient-centered coordinated-care management processes. NCQA recognition requires that practices identify clinically significant conditions and demonstrate their ability to meet the six PCMH 2011 standards:

  • Enhance access to and continuity of care
  • Identify and manage patient populations
  • Plan and manage patient care
  • Provide self-care support and community resources
  • Track and coordinate care
  • Measure and improve practice performance
  • It provides the foundation to develop a practice culture of continuous quality improvement. It can also assist a practice in developing the necessary infrastructure to embrace quality improvement programs and mandates.
  • It can assist providers in accomplishing Quality Improvement research projects necessary to fulfill the American Board of Pediatrics’ MOC requirements.
  • It prepares a practice to fulfill multiple Meaningful Use measures. 
  • It improves practice management efficiencies that produce marked savings in areas such as inventory, personnel, scheduling, risk management and time management.
  • It can assist a practice in improving existing and obtaining new revenue streams, including pay-for-performance programs (such as Amerigroup’s PQIP and Wellcare’s HEDIS programs). An increasing number of CMOs and insurance companies also provide separate incentive payments for NCQA-recognized medical homes.
  • It—most importantly—brings substantial improvement in patient satisfaction and clinical outcomes.