The PCMH Recognition Process
To become an NCQA-Recognized Patient-Centered Medical Home (PCMH), a primary care practice learns the NCQA PCMH concepts and required criteria and begins the transformation process. NCQA conducts online check-ins to assess the practice’s progress and discuss the next steps in the evaluation. A practice that meets the criteria earns NCQA Recognition.
COMMIT
Learn the Requirements
Review the PCMH Concepts Overview and download the NCQA Standards and Guidelines document.
Begin learning the concept areas and required criteria.
Review our online and in-person training, which can help you better understand the recognition process and requirements.
Apply PCMH Criteria to the Practice
Implement changes in your practice that align with PCMH criteria.
Decide which requirements you want to submit and how you want to demonstrate evidence.
Use Q-PASS to upload evidence (such as policies and procedures). You may demonstrate other requirements in real time during the virtual review through screen-sharing technology. Screen-sharing technology eliminates the need to upload documentation in advance.
Enroll
When you are familiar with the concepts and have started to transform, create a QPASS account at qpass.ncqa.org
Complete an initial questionnaire and pay your enrollment fee.
Learn more about the steps to enroll and what is required at enrollment.
TRANSFORM
Kick-Off Call
Once enrolled, NCQA assigns a representative to guide your practice through the recognition process.
Your Representative will schedule an initial call to introduce themselves, discuss the process and develop a review schedule of up to three check-ins over the course of your transformation work.
If you have more than one site, your representative can provide you guidance on setting up site groups and sharing evidence across sites.
Apply Concepts To Your Practice
Implement changes in your practice that align with the PCMH concepts.
Virtual Reviews
Practices have up to 3 virtual reviews using screen-sharing technology.
Virtual reviews allow you to share your screen to show you meet NCQA PCMH requirements instead of submitting documentation.
Virtual reviews give immediate and personalized feedback on what is going well and what needs to improve. Learn what to expect during the virtual review.
SUCCEED
Earn Recognition
NCQA reviews the submission one last time and notifies practices of their recognition status.
Once notified of recognition, practices go into Q-PASS and print their Recognition Certificate.
Annual Reporting
Your practice performs ongoing quality improvement.
Your practice submits evidence of this to NCQA during Annual Reporting to sustain recognition and succeed as a PCMH recognized practice.
Benefits of PCMH outside of the Financial Incentives
Improved patient health outcomes: By focusing on coordinated, patient-centered care, PCMHs can improve the
overall health of their patients. This can lead to fewer hospitalizations, reduced complications, and better
management of chronic conditions. Enhanced coordination and patient-centered care lead to better overall health,
fewer hospitalizations, and reduced complications.
Reduced healthcare costs: Proactive care management and reduced unnecessary services lower healthcare costs for both Centrum Health and patients. By improving patient health and reducing unnecessary hospitalizations and procedures, PCMHs can help lower healthcare costs for both patients and payers.
Increased revenue: PCMHs are eligible for financial incentives from payers and government programs. Additionally,
by improving patient satisfaction and outcomes, PCMHs may attract more patients and increase their revenue.
PCMH recognition opens doors to financial incentives from payers and government programs. Improved patient
satisfaction and outcomes attract more patients, further boosting revenue.
Improved efficiency and productivity: By streamlining care processes and utilizing technology, PCMHs can
improve efficiency and productivity, leading to cost savings and improved patient care. Streamlined processes and
technology integration improve efficiency and productivity, optimizing resource utilization and patient care.