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NCQA Redesigns Patient-Centered Medical Home Recognition Program

By Sandra Gittlen  
   March 22, 2017

Pritza started the PCMH recognition journey in 2012 by creating a pilot clinic at one site. That site achieved Level 3 recognition in 2013, and it was just re-upped for the 2014 standard. He created a learning lab on how to get certified and on the benefits of the NCQA PCMH recognition. Likewise, The Physician Network was able to get eight clinics certified in 2015 and 2016. Both organizations have been working to expand their recognition pool and continue to share their transformation best practices with the greater CHI collaborative.

"We have an aggressive timeline to have the majority of our clinics certified," Pritza says, but had run into roadblocks each time NCQA updated guidelines for each of the levels. "It makes the bar more complicated and forces us to think how we're going to achieve our goals," he says.

Hoover says organizations should realize that the process could take longer and require more human resources than expected. "Make sure you've resourced the efforts around this journey well," he says. "It's more a long-distance race than a sprint."

"You definitely won't be able to turn it around in 30, 60, or even 90 days," Pritza says. "You're dealing with a culture change on how you deliver care that a lot of doctors just aren't ready for."

As for NCQA's PCMH evolution, Hoover is hopeful. "My personal sense is it's evolving in the right direction," he says. "However, it would serve them well to focus on things that have positive patient impact, more so than process issues."


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