The National Committee for Quality Assurance has recognized nearly 7,000 sites as patient-centered medical homes since its recognition program launched in 2008. Now, the NCQA is updating its standards for recognition.
The last time the NCQA updated its standards was 2011. The official launch date for the latest edition of standards is March 24, but sites can apply for recognition under 2011 standards until March 31, 2015.
Similar to the 2011 PCMH standards, there are six main standards for recognition in the 2014 update. However, the standards themselves have changed slightly to "raise the bar" for PCMH recognition. The following is a breakdown of some of the more major changes.
• More emphasis on team-based care. Team-based care is now its own separate standard, differing from being lumped in with patient-centered access in the 2011 version. Additionally, team-based care is a "must-pass" criterion for recognition. The new requirements also emphasize the patient's role on the team more so than previous iterations.
• Further integration of behavioral health. The updated model "lays the foundation for developing integrated behavioral health services," Kimberly Williams, vice president of the Center for Policy, Advocacy and Education at the Mental Health Association of New York City, said during a press call.
Under the new standards, practices must include a disclosure to patients on how their behavioral health needs will be addressed. This will make behavioral health issues more "regularly and readily discussed," Ms. Williams said, thus reducing the stigma that can be associated with these types of health concerns, such as depression and anxiety disorders. Additionally, the new standards encourage practices to establish referral agreements with behavioral health providers.
• Explicit alignment with the triple aim. The updated standards now explicitly align with the three aspects of the triple aim — cost, quality and patient experience improvement. Each aspect must be addressed through quality improvement activities to receive related credit, said Patricia Barrett, NCQA vice president of product development.
• Focus on high-need populations for care management. More so than in the past, the 2014 standards are more focused on care management for high-need populations. The standards encourage practices to address socioeconomic drivers of health, such as transportation issues or those without the support of family or friends, according to Ms. Barrett.
• Sustained transformation guidelines. Ms. Barrett called the medical home a "constantly evolving creation," saying "if anyone stands still, they are likely to fall behind." The NCQA now expects the practices to demonstrate they made changes in the months leading up to submitting for recognition, so the changes were not just put in place to gain NCQA PCMH recognition. There "can't [be] wet ink at the time of recognition," she said.
Practices recognized under the 2011 PCMH standards will have valid recognition for three years from the date of recognition.