PCC PCMH Resources: Difference between revisions

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This wiki serves as an informal repository of PCMH documentation related to the 2011 and 2014 PCMH Standards.  Much of the content here comes from PCC clients who have generously allowed us to use their material.  Nothing in this wiki is official PCC documentation and should be used at your own risk.
This wiki serves as an informal repository of PCMH documentation related to NCQA's 2017 Standards.  Some of the content here comes from PCC clients who have generously allowed us to use their material.  Nothing in this wiki is official PCC documentation and should be used at your own risk.


[http://pcmh.pcc.com/index.php/2011_Main PCC's Resources for 2011 PCMH Standards]
[http://pcmh.pcc.com/index.php/2017_Main PCC's Resources for 2017 PCMH Standards]


[http://pcmh.pcc.com/index.php/2014_Main PCC's Resources for 2014 PCMH Standards]
[http://pcmh.pcc.com/index.php/2014_Main PCC's Resources for 2014 PCMH Standards] <span style="color:red">(Outdated as of October, 2017)</span>


= 2011 PCMH Standards =
= Why Get PCMH Recognition? =


In January 2011, [http://ncqa.org NCQA] released [http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/DuringEarnItPCMH/OtherPCMHResources.aspx#PCMH%20(2011) new standards] for its Patient-Centered Medical Home program, replacing the PPC-PCMH 2008 standards and calling medical practices to be more patient-centered, and to reinforce federal “meaningful use” incentives for primary care practices to adopt health information technology.  
NCQA PCMH Recognition is the most widely-used way to transform primary care practices into medical homes. More than 12,000 practices (with more than 60,000 clinicians) are recognized - about 18 percent of all primary care clinicians.


PCC has organized [http://pcmh.pcc.com/index.php/2011_Main the 2011 PCMH Standards] in this wiki to provide quick reference to the 2011 standards themselves and, where applicable, documentation showing how PCC functionality applies to individual PCMH factors.  In some cases, PCC clients have also generously allowed us to reference their material.
Benefits for clinicians include:
*Earn higher reimbursement. More than 50 payers nationwide offer enhanced reimbursement for recognized clinicians or support for practices to become recognized.
*Earn Maintenance of Certification (MOC) credits. Several medical boards award clinicians in NCQA-recognized practices Maintenance of Certification (MOC) credits, reducing the burden on clinicians to take on additional activities.
*Focus on patient care. The PCMH model ensures that team members operate at the highest level of their knowledge, skills, abilities and license, within their assigned roles and responsibilities.


'''Note:''' On March 24, 2014 NCQA released a set of [http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/DuringEarnItPCMH/OtherPCMHResources.aspx#PCMH%20(2014) new 2014 Standards]. As of June 30, 2014 you can no longer purchase the PCMH 2011 survey tools. If you purchased the 2011 survey tools prior to June 30, 2014 you have until March 31, 2015 to submit your application to NCQA based on 2011 standards.  If you are interested in achieving PCMH recognition but have not purchased the survey tools prior to 6/30/14, you must use the new 2014 PCMH standards.
NCQA Resources
*[http://www.ncqa.org/Portals/0/qpass/NCQA1074-0317_Getting_Started_Toolkit_Web.pdf Toolkit: Getting Started with NCQA PCMH Recognition]
*[http://www.ncqa.org/Portals/0/Programs/Recognition/PCMH/NCQA1005-1016_PCMH%20Evidence_Web.pdf Evidence Report]
*[http://www.ncqa.org/education-training/pcmh-pcsp Training On-site or On-demand]
*[http://www.ncqa.org/Portals/0/Programs/Recognition/Resources/02012018_Resource_Directory_of_Incentives_for_NCQA_Recognition.pdf Resource Directory of Incentives for NCQA Recognition]


= 2014 PCMH Standards =
= PCC Collaboration with The Verden Group's Patient Centered Solutions =


On March 24, 2014 NCQA released a set of [http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/DuringEarnItPCMH/OtherPCMHResources.aspx#PCMH%20(2014) new 2014 Standards].  These new standards along with a survey tool can now be reviewed and downloaded from [http://store.ncqa.org/index.php/recognition/patient-centered-medical-home-pcmh.html NCQA's web site].   
[http://www.theverdengroup.com/our-services/patient-centered-solutions-services The Verden Group’s Patient Centered Solutions (PCS)] has collaborated with PCC to provide a comprehensive program assisting PCC clients in achieving NCQA's PCMH 2014 Recognition.  Contact PCC for more details on this offering.


PCC has organized [http://pcmh.pcc.com/index.php/2014_Main the 2014 PCMH Standards] in this wiki to provide quick reference to the 2014 standards themselves and, where applicable, documentation showing how PCC functionality applies to individual PCMH factors.  In some cases, PCC clients have also generously allowed us to reference their material.
= 2017 PCMH Standards =


= PCC Prevalidation =
NCQA has redesigned PCMH Recognition. The redesigned program includes ongoing, sustained recognition status with Annual Reporting instead of a 3-year recognition cycle. NCQA based the redesign on feedback from practices, policy makers, payers and other stakeholders. The program is more manageable, while continuing to concentrate on performance and quality improvement. It also reduces paperwork and increases practice interaction with NCQA.  With the redesigned process came [http://www.ncqa.org/programs/recognition/practices/patient-centered-medical-home-pcmh/getting-recognized/documents new 2017 standards] that were released in April, 2017. 


Practices looking to achieve PCMH recognition using NCQA's 2011 standards may now receive up to '''16.25 transferable auto credits''' using PCC, its patient portal, and ePrescribing system. This means practices using PCC can automatically transfer 16.25 points toward the 85 total points needed to
PCC has organized [http://pcmh.pcc.com/index.php/2017_Main the 2017 PCMH Standards] in this wiki to provide quick reference to the 2017 standards themselves and, where applicable, documentation showing how PCC functionality applies to individual PCMH factors. In some cases, PCC clients have also generously allowed us to reference their material.
achieve NCQA Level 3 Medical Home status.


NCQA also recognized that PCC's EHR and practice management systems provide the necessary supporting tools and information for practices to achieve an additional 25.5 points towards PCMH recognition.
= PCC Prevalidation =


Each PCC client practice that wishes to apply for NCQA PCMH 2011 Recognition will need to complete the following steps to use PCC's prevalidated status:
As of 03/07/2018, practices utilizing PCC can benefit from reduced documentation for criteria designated as “partially met criteria” and have criteria designated as “fully met criteria” marked as “met” in full.  As documented in the [[media:PCC_PrevalidationLOE_6.18.2020_(2).pdf|PCMH 2017 Letter of Credit Approval/Transfer Credit Summary]], each PCC client practice that wishes to apply for NCQA PCMH 2017 Recognition will need to complete the following steps to use PCC's prevalidated status:


* Step 1: Purchase a survey tool from NCQA for a fee of $80.00, payable to NCQA.
#Download the NCQA-issued [[media:PCC_PrevalidationLOE_6.18.2020_(2).pdf|PCMH 2017 Letter of Credit Approval/Transfer Credit Summary]]
* Step 2: Obtain from PCC the NCQA-issued [[Media:NCQA_PCMH_PCC_Summary_Approval_Table.pdf | PCC Prevalidation Summary Approval Table]] and [[Media:Letter_of_Autocredit_Approval.pdf | NCQA Letter of Product Autocredit Approval]] necessary for submission for NCQA Recognition.
#Contact PCC to get a Letter of Product Implementation indicating which prevalidated tool(s)/modules approved for autocredit have been implemented at your practice.
* Step 3: Implement NCQA Prevalidated Product(s) at minimum 3 months prior to submission of NCQA PCMH 2011 Survey Tool.
#Log-In to QPASS and complete the following steps:
* Step 4: Complete an application and enter into such agreements with NCQA as may be required under that Recognition Program.
#*Click “My Evaluations”
* Step 5: Agree that its compliance with the requirements of the Recognition Program is subject to audit by NCQA.
#*Hover over Action and select “Organization Dashboard”
* Step 6: Upload [[Media:NCQA_PCMH_PCC_Summary_Approval_Table.pdf | PCC Prevalidation Summary Approval Table]]  with the inclusion of product implementation date across practice site and a copy of the [[Media:Letter_of_Autocredit_Approval.pdf | NCQA Letter of Product Autocredit Approval]] to Document Library of practice’s PCMH 2011 survey.
#*Select “Transfer Credits” button
* Step 7: Prior to submission of NCQA PCMH 2011 Survey Tool, upload all specified documentation into the Document Library of the ISS Survey Tool and for each Element where awarded autocredit is available, enter the associated product’s Attestation Statement indicated at the bottom of the Letter of Product Autocredit Approval.
#*On the “Select Program” screen, pick “Vendor”
#*Select the applicable practice site(s)
#*Using the evidence component, upload the Letter of Product Implementation
#*Click the “Submit for Review” button
#Receive approval from your NCQA Representative. Once your transfer credit is approved, all eligible criteria with transfer credit will be marked as “met.”


= Other Resources =
= Other Resources =
[http://pcmh.pcc.com/index.php/2011_Main PCC's Resources for previous 2011 PCMH Standards]


[[media:Chart_Review_Rubrics_for_3C,_3D,_4A.pdf|Chart Review Rubrics for 3C, 3D, and 4A]] courtesy of Plateau Pediatrics in TN
[[media:Chart_Review_Rubrics_for_3C,_3D,_4A.pdf|Chart Review Rubrics for 3C, 3D, and 4A]] courtesy of Plateau Pediatrics in TN


[[media:MU-PCMH.pdf|Crosswalk of Meaningful Use components between 2011 and 2014 PCMH]]
[[media:MU-Crosswalk-new.pdf|Crosswalk of Meaningful Use components to 2014 PCMH standards]]


[http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/DuringEarnItPCMH/OtherPCMHResources/FAQsforPediatricPractices.aspx FAQ for pediatric practices related to 2011 PCMH Standards]
[http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/DuringEarnItPCMH/OtherPCMHResources/FAQsforPediatricPractices.aspx FAQ for pediatric practices related to 2011 PCMH Standards]
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[http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/PCMH2014ContentandScoringSummary.aspx NCQA PCMH 2014: Behind the Enhancements] free webinar download
[http://www.ncqa.org/Programs/Recognition/Practices/PatientCenteredMedicalHomePCMH/PCMH2014ContentandScoringSummary.aspx NCQA PCMH 2014: Behind the Enhancements] free webinar download


[http://www.ncqa.org/Programs/Recognition/RelevanttoAllRecognition/RecognitionTraining.aspx NCQA's other PCMH recognition training]
[http://www.ncqa.org/education-training/pcmh-pcsp NCQA's recorded PCMH recognition training]

Latest revision as of 16:59, 8 January 2021

This wiki serves as an informal repository of PCMH documentation related to NCQA's 2017 Standards. Some of the content here comes from PCC clients who have generously allowed us to use their material. Nothing in this wiki is official PCC documentation and should be used at your own risk.

PCC's Resources for 2017 PCMH Standards

PCC's Resources for 2014 PCMH Standards (Outdated as of October, 2017)

Why Get PCMH Recognition?

NCQA PCMH Recognition is the most widely-used way to transform primary care practices into medical homes. More than 12,000 practices (with more than 60,000 clinicians) are recognized - about 18 percent of all primary care clinicians.

Benefits for clinicians include:

  • Earn higher reimbursement. More than 50 payers nationwide offer enhanced reimbursement for recognized clinicians or support for practices to become recognized.
  • Earn Maintenance of Certification (MOC) credits. Several medical boards award clinicians in NCQA-recognized practices Maintenance of Certification (MOC) credits, reducing the burden on clinicians to take on additional activities.
  • Focus on patient care. The PCMH model ensures that team members operate at the highest level of their knowledge, skills, abilities and license, within their assigned roles and responsibilities.

NCQA Resources

PCC Collaboration with The Verden Group's Patient Centered Solutions

The Verden Group’s Patient Centered Solutions (PCS) has collaborated with PCC to provide a comprehensive program assisting PCC clients in achieving NCQA's PCMH 2014 Recognition. Contact PCC for more details on this offering.

2017 PCMH Standards

NCQA has redesigned PCMH Recognition. The redesigned program includes ongoing, sustained recognition status with Annual Reporting instead of a 3-year recognition cycle. NCQA based the redesign on feedback from practices, policy makers, payers and other stakeholders. The program is more manageable, while continuing to concentrate on performance and quality improvement. It also reduces paperwork and increases practice interaction with NCQA. With the redesigned process came new 2017 standards that were released in April, 2017.

PCC has organized the 2017 PCMH Standards in this wiki to provide quick reference to the 2017 standards themselves and, where applicable, documentation showing how PCC functionality applies to individual PCMH factors. In some cases, PCC clients have also generously allowed us to reference their material.

PCC Prevalidation

As of 03/07/2018, practices utilizing PCC can benefit from reduced documentation for criteria designated as “partially met criteria” and have criteria designated as “fully met criteria” marked as “met” in full. As documented in the PCMH 2017 Letter of Credit Approval/Transfer Credit Summary, each PCC client practice that wishes to apply for NCQA PCMH 2017 Recognition will need to complete the following steps to use PCC's prevalidated status:

  1. Download the NCQA-issued PCMH 2017 Letter of Credit Approval/Transfer Credit Summary
  2. Contact PCC to get a Letter of Product Implementation indicating which prevalidated tool(s)/modules approved for autocredit have been implemented at your practice.
  3. Log-In to QPASS and complete the following steps:
    • Click “My Evaluations”
    • Hover over Action and select “Organization Dashboard”
    • Select “Transfer Credits” button
    • On the “Select Program” screen, pick “Vendor”
    • Select the applicable practice site(s)
    • Using the evidence component, upload the Letter of Product Implementation
    • Click the “Submit for Review” button
  4. Receive approval from your NCQA Representative. Once your transfer credit is approved, all eligible criteria with transfer credit will be marked as “met.”

Other Resources

PCC's Resources for previous 2011 PCMH Standards

Chart Review Rubrics for 3C, 3D, and 4A courtesy of Plateau Pediatrics in TN

Crosswalk of Meaningful Use components to 2014 PCMH standards

FAQ for pediatric practices related to 2011 PCMH Standards

NCQA's Pricing and Fee Schedule for PCMH Recognition

NCQA Clarifications/Corrections on 2014 PCMH Standards

NCQA's PCMH 2011–PCMH 2014 Crosswalk

NCQA's 2014 PCMH Content and Scoring Summary

NCQA PCMH 2014: Behind the Enhancements free webinar download

NCQA's recorded PCMH recognition training

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