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NCQA Medical Home Recognition

New Guide Helps FPs Navigate Documentation Process

By Sheri Porter
1/9/2009

As the patient-centered medical home, or PCMH, concept gathers steam and grabs the interest of public and private payers, family medicine finds itself in the spotlight. As a service to members, the AAFP has produced a guide to help FPs who are interested in achieving PCMH recognition from the National Committee for Quality Assurance, or NCQA.
On Your Behalf
"Road to Recognition -- Your Guide to NCQA Medical Home" is available free to members and can be downloaded from the Academy's Web site. Members need their AAFP ID number to access the guide.

The guide was supported in part by grants from the United Health Foundation and Pfizer Inc.

NCQA, a not-for-profit organization dedicated to improving health care quality, introduced its Physician Practice Connections -- Patient-Centered Medical Home program in January 2008. The NCQA program uses standards that are aligned with the Joint Principles of the Patient-Centered Medical Home (3-page PDF; About PDFs) to designate family medicine practices as medical homes.

For a fee, practices can achieve one of three levels of recognition as they implement and document program requirements.

Bruce Bagley, M.D., the AAFP's medical director of quality improvement, said the Academy acted to produce the guide after hearing member feedback that the NCQA medical home documentation process was complex and nearly unmanageable.

"We've provided tools, examples and templates to make that process as painless and as easy as possible," said Bagley. "We've tried to break it down into manageable steps." The first step in using the multi-faceted guide is to read through the NCQA standards to understand how they are constructed and scored, he said.

Bagley added that NCQA medical home recognition would do more than give FPs in some markets an opportunity to earn bonus payments. "The process also benefits physicians in terms of improved practice efficiency and practice organization," said Bagley.

Although the NCQA recognition process is entirely voluntary, Bagley said physicians who choose not to participate are missing an important opportunity. "It's not just about jumping over a hurdle to get some money; it's about making your office work better."

NCQA's $450-per-physician fee for review and recognition is a barrier, particularly for physicians who live in areas devoid of payers who are offering bonus money to participate, said Bagley. Physicians may not want to go the whole nine yards to get the recognition if they don't see any financial advantage, he acknowledged.

But those physicians can download the standards from the NCQA Web site for no charge "and use them as a checklist for projects and processes that probably should be done anyway," said Bagley.