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Patient Centered Medical Homes

The National Committee for Quality Assurance (NCQA) has pre-validated Centricity Practice Solution versions 11 and 12 for use in Patient Centered Medical Homes (PCMH). The highly collaborative, accountable, and flexible solution seamlessly fits the mission of the NCQA: “to improve the quality of healthcare through measurement, transparency and accountability.” With the implementation of CPS, eligible primary care providers receive autocredit towards their application for PCMH status. At Quatris Health, we appreciate the benefits of this new care model for our providers and their patients.  Each of our four service lines – sales, service, support, and cloud – collaborate to ensure our eligible providers receive PCMH recognition.

Call us today to learn more about your eligibility for PCMH, or browse our FAQ’s and other resources from the NCQA below.

Ammonoosuc Case Study-PCMH

What is a PCMH?

NCQA description:

“A patient-centered medical home is a model of care that strengthens the physician-patient relationship by replacing episodic care with coordinated care and a long-term healing relationship. Each patient has an ongoing relationship with a personal physician who leads a team at a single location that takes collective responsibility for patient care, providing for the patient’s healthcare needs and arranging for appropriate care with other qualified clinicians. The medical home is intended to result in more personalized, coordinated, effective and efficient {patient} care.

“A medical home achieves these goals through a high level of accessibility, providing excellent communication among patients, physicians and staff and taking full advantage of the latest information technology to prescribe, communicate, track test results, obtain clinical support information and monitor performance.”

What are the key organizational attributes of a PCMH?

  • Patient-centered focus
  • Collaborative care team
  • Data-driven care model
  • Continuous improvement

What are the key elements of Centricity Practice Solution that are helpful to a PCMH?

  • Tools to increase patient access and engagement
  • Care collaboration tools
  • Reporting on patient population data
  • Customizable workflow and templates

Who can become one?

Primary Care in Ambulatory Setting: The model is intended for practices that act as the main care provider for their patient population in an ambulatory setting. Primary care physicians represent most of the recognized practices – including family practitioners, general practitioners, internists and pediatricians.

Chronic care treatment centers: If a practice can demonstrate that it provides whole person care and meets the other elements of the joint principles for most of its patients (at least 75 percent), it can be eligible for PCMH recognition by NCQA even if it is not a traditional primary care practice. An example might include a hemophilia treatment center.

Nurse-led practices (state-dependent): Nurse-led practices may achieve medical home recognition in states where state licensing designates nurse-practitioners as independent practitioners.

How does a site become recognized?

NCQA offers 3 levels of recognition. Level 3 is the highest. Practice sites are scored against 152 factors that are grouped into various elements within 6 standards.

6 standards

  • Enhance access and continuity
  • Identify and manage patient populations
  • Plan and manage care
  • Provide self-care support and community resources
  • Track and coordinate care
  • Measure and improve performance

There is one must-pass element within each standard and a number of must-pass factors within the various elements. Recognition is not practice-wide but rather offered on a site by site basis. Sites must supply evidence of meeting criteria and document processes used.

Where can I get a list of the 152 factors and how NCQA scores them?

Click on the following link to view NCQA’s 2014 Standards, Elements, and Factors for PCMH recognition.

For additional information including the way each element is scored, please refer to the two presentations accessible from this page.

Is Centricity Practice Solution prevalidated?

Yes, Centricity Practice Solution Version 11 and 12 are PCMH prevalidated by NCQA to receive autocredit toward NCQA’s PCMH 2014 scoring.

What does this mean for practices?

Approved autocredit is transferrable to practices utilizing the prevalidated product’s functionality* eliminating the provision of documentation for the factors awarded autocredit within their Patient-Centered Medical Home (PCMH) 2014 survey.
*Note: All prevalidated products must be in place a minimum of 3 months prior to submission of PCMH ISS Survey Tool.

Practices should contact Quatris Support for a letter confirming the implementation timeframe.

PCMH eligible client practices must be actively utilizing the reviewed capabilities associated with the PCMH prevalidated product in order to be eligible for transfer of awarded autocredit. Practices should reference the PCMH 2014 Prevalidation

Additional Resources:

http://www.ncqa.org/Portals/0/Public%20Policy/HIMSS_NCQA_PCMH_Factsheet.pdf
Free training from NCQA: http://www.ncqa.org/tabid/109/Default.aspx under section “Patient-Centered Medical Home”