NCQA Program to Evaluate Patient-Centered Medical Homes

(NCQA: Washington, DC) -- The National Committee for Quality Assurance launched a new version of its Physician Practice Connections (PPC) program designed to assess how medical practices are functioning as patient-centered medical homes. The new Physician Practice Connections—Patient-Centered Medical Home (PPC-PCMH) emphasizes the systematic use of patient-centered, coordinated care management processes.

The medical home is a promising approach that seeks to strengthen the patient-physician relationship by replacing episodic care with coordinated care and a long-term healing relationship. The medical home is defined as a model of care where each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician-led care team is responsible for providing all the patient’s health care needs and, when needed, coordinating care across the health care system. A medical home also emphasizes enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff.

“The Patient-Centered Medical Home has the potential to change the interaction between patients and physicians from a series of episodic office visits to an ongoing two-way relationship,” says NCQA president Margaret E. O’Kane. “Patients can no longer be silent partners in their care – they are active participants in managing their health with a shared goal of staying as healthy as possible.”

PPC-PCMH includes nine standards for medical practices to meet, including use of patient self-management support, care coordination, evidence-based guidelines for chronic conditions, and performance reporting and improvement. To be recognized as a patient-centered medical home, practices will need to demonstrate the ability to sufficiently meet the criteria of these standards (i.e. achieve a minimum of 25 points out of 100 to attain the first of three levels of recognition) and specifically pass at least five of 10 elements, which include adoption and implementation of evidence-based guidelines, use of data to show standards for patient access and communication, and systematic tracking of test results and identification of abnormal results.

Large employers have also embraced the patient-centered medical home concept. “Through the PPC-PCMH, NCQA is helping physicians understand what functioning as a patient-centered medical home means on a day-to-day basis for their practices and establishing standards to recognize physicians who provide this type of care,” says John Tooker, executive vice president and CEO of the American College of Physicians.

PPC-PCMH joins four NCQA programs designed to recognize excellence in patient care in medical practices. Along with PPC, the programs focus on caring for patients with diabetes, cardiovascular disease or stroke, and back pain.

For more information, visit www.ncqa.org/tabid/641/Default.aspx

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