NCQA updates Patient-centered Medical Home recognition standards

The National Committee for Quality Assurance (NCQA) has updated its recognition standards for Patient-centered Medical Homes (PCMH). The 2014 guidelines emphasize team-based care coordination, behavioral health integration, and care for high-need populations.

“This latest generation of patient-centered medical home standards is an important step in the evolution of primary care into what patients want it to be: coordinated and focused on them,” NCQA President Margaret E. O’Kane said in a written statement. “Patient-centered medical home 2014 raises the bar, especially with its emphasis on behavioral healthcare and care management for high-need populations.”

The new requirements acknowledge that socioeconomic status plays an important role in a patient’s overall health, so practices must focus on high-need populations, including those with chronic conditions, within their “medical neighborhood.” In order to receive PCMH recognition, practices must also collaborate with behavioral healthcare providers and work to integrate those services.

The guidelines state, “Practices must show that they are working to improve across all three domains of the triple aim: patient experience, cost and clinical quality.”

Last month the success for the PCMH model was called into question by a study published in the Journal of the American Medical Association that examined a pilot program in southeastern Pennsylvania. It found that the PCMH model has not led to a significant reduction in healthcare costs, and it has not improved overall healthcare outcomes for chronically ill patients.

However, the NCQA responded to that study by saying the program lacked the features of current PCMH models, including cost reduction incentives and a significant number of Level 3 medical homes.