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Meaningful use incentives included in new PCMH standards

January 31, 2011 | Molly Merrill, Contributing Editor

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WASHINGTON – The National Committee for Quality Assurance has released new standards for a patient centered medical home, with changes including improved access to care, a more defined patient experience and the incorporation of meaningful use incentives.

The PCMH, a model of care emphasizing care coordination and communication, has seen a 3,400 percent increase in recognized clinicians and a 5,200 percent increase in recognized sites since 2008.  Almost 7,700 clinicians at more than 1,500 sites across the United States have used the NCQA standards to become high-quality primary care practices and receive recognition as PCMHs.

[Read why the PCMH is good for costs: New York BCBS launches patient-centered medical home pilot]

Officials say the PCMH 2011 release marks the next generation of the NCQA recognition program, which designates high-quality primary care practices as patient-centered medical homes.

PCMH 2011 directs practices to organize care according to patients' preferences and needs. Standards emphasize access to care during and after office hours and managing care in collaboration with patients and families. Other aspects include providing services in preferred languages, helping patients with self-care and facilitating access to community resources.

PCMH 2011's emphasis on patient feedback supports what is widely known as the "triple aim" (improving quality, containing costs and enhancing patient experience). NCQA is collaborating with the Agency for Healthcare Research and Quality to develop a medical home version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Survey, a widely used evaluation of patient experience. The NCQA expects to release CAHPS for medical homes in the second half of 2011. Starting in January 2012, practices may receive additional NCQA distinction by voluntarily reporting patient experience data.

To support patient-centered care for children, PCMH 2011 standards include parental decision-making, teen privacy and guardianship. Standards also cover communication between medical facilities about newborns' lab results and guidelines for planning the transition from pediatric to adult care.

"NCQA's new medical home standards will enhance care coordination, clinician and staff satisfaction and primary care quality nationwide, while putting patients in the driver's seat to manage their health," said Susan Edgman-Levitan, leader of the 22-member advisory committee that helped the NCQA create PCMH 2011 and executive director of the Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital.

[Read about a PCMH project that includes 11 practices: L.A. Care launches patient-centered medical home pilot ]

Federal meaningful use language is embedded in PCMH 2011 evaluation standards, reinforcing incentives for practices to use health information technology to improve quality. Officials say the alignment with meaningful use creates a cycle: Practices that meet PCMH 2011 requirements will be well prepared to qualify for meaningful use, and vice versa.

"PCMH 2011 advances the patient-centered medical home as a paragon of 21st Century primary care," said NCQA President Margaret E. O'Kane. "By emphasizing access, health information technology and partnerships between clinicians and patients to improve health, these new standards raise the bar in defining high-quality care."

Click here to download the 2011 PCMH Standards and Guidelines.

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