PCMH Recognition-Better Quality, Happier Patients, Lower Costs

January 9, 2018

The Patient-Centered Medical Home (PCMH) model is the driving force behind some of the most important reforms in healthcare delivery today. According to the National Committee for Quality Assurance (NCQA), PCMH’s are saving money by reducing hospital and emergency department visits, minimizing health disparities, and improving patient outcomes.

NCQA has redesigned the PCMH Recognition program after incorporating feedback from practice staff, clinicians and NCQA PCMH Certified Content Experts to improve the process, reduce the associated paperwork and simplify reporting so that practices can focus more on patients and improving care.

For patients this means a better experience! They can stay healthier through care management assistance for chronic conditions, receive preventive services and screenings at a higher rate than patients who are not in PCMH. In addition, with enhanced patient access, fostering a more proactive approach for their personal care needs.

For providers, recognition will promote building a solid infrastructure which focuses on quality improvement initiatives, supporting revenue growth with federal, state and commercial payers offering incentive programs to practices achieving NCQA PCMH/PCSP Recognition. Practices will notice improvements in workflow based on implementing processes and procedures making the practice more efficient. The streamlined processes will standardize care and allow team members to operate at the highest level of their education, skills and licensure.

Lastly, the Centers for Medicare & Medicaid Services (CMS) acknowledge both PCMH and Patient Centered Specialty (PCSP) recognition programs as ways to receive MACRA (Medicare Access and CHIP Reauthorization Act) credit. Clinicians in NCQA-Recognized PCMHs/PCSPs will automatically earn full credit in the MIPS (Merit-Based Incentive Payment System).

For more information on what PCMH recognition and it’s benefits you can visit NCQA PCMH Evidence Report October 2017.

Cristina Oliveri

PCMH Facilitator, RR Health Strategies