• PCMH Incentive, Recognition, and Accreditation Programs

    PCMH Incentive Programs

    Patient-centered medical home (PCMH) incentive programs are local, state, and public/private payer initiatives that offer payment incentives to participating practices that adopt the functions of a PCMH. To determine whether such initiatives exist in your area:

    Examples of national initiatives that may be operating in your state include the following program from the Centers for Medicare and Medicaid Services:

    • Comprehensive Primary Care Plus (CPC+): The CPC+ model is an opportunity for primary care to receive better, more flexible payment and participate in a robust learning community to better meet patient needs. CPC+ is currently being tested in two rounds in 18 regions supported by 66 aligned payers.

    Note: PCMH incentive programs may require participation in a designated PCMH recognition or accreditation program (learn more below).

    PCMH Recognition and Accreditation Programs

    A number of local, state, and national PCMH recognition and accreditation programs are available. PCMH recognition is voluntary for many practices, but some practices are required to complete a PCMH recognition program (e.g., for participation in an accountable care organization [ACO] or PCMH incentive program).

    To determine whether your practice is required to participate in a recognition or accreditation program, refer to your ACO, PCMH incentive program, federal grant (e.g., Health Resources and Services Administration), and major practice payer (e.g., Medicaid, private insurance, etc.) agreements. If recognition is required, your agreement will typically designate a specific recognition program for you to complete.

    If you are not required to participate in a recognition program but choose to do so anyway, research the available programs to determine which is most appropriate for your practice. Be sure to consider the application cost, data and documentation requirements, and staff resources required to complete the application process. Use this information to formulate a complete picture of the total costs—monetary and resource-wise—associated with each program.

    National Recognition and Accreditation Programs