NCQA designed its PCMH and PSCP recognition processes to help practices define the standards for patient-centered structure and articulate the necessary change processes. Many practices and organizations choose to evolve to capitalize on opportunities for compensation, as several private payers and state Medicaid programs recognize and reward medical homes through care coordination fees, increased payment for evaluation and management services, or quality and outcome bonuses. Process changes must take place for workflow and increased efficiency, but culture change also is pivotal, including:

  • A transition from physician-oriented focus to a patient-centric focus
  • Activating patients’ engagement with their health and wellness
  • Establishing the primary care provider as a first point of contact for care

Adoption of this model requires visionary leadership, communication with and education of the staff, management of the practice’s entire patient population and, most importantly, the ability to manage change as a team.

Many practices seek NCQA recognition to ensure their patients get the best care at the right time. Participation in this program demonstrates a provider's commitment to follow specific guidelines to improve their patients’ health.

Here are some lessons learned from one of our clients, a provider system that is working with practices to achieve NCQA recognition*:

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on 20 Dec 2017 12:00 AM
  • PCMH
  • NCQA