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Increasing Future Reimbursement via Patient Centered Medical Homes


The latest buzz in primary care is the development of the Patient Centered Medical Home (PCMH). What is a Medical Home? The American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association have jointly defined the medical home as:
"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, arranges for appropriate care with other qualified physicians. A medical home also emphasizes enhanced care through open scheduling, expanded hours and communication between patients, physicians and staff."

How can your practice be part of the NCQA Recognition Program and receive the designation of PCMH? The National Committee for Quality Assurance provides survey tools for practices to determine if they are appropriate candidates for inclusion in the Medical Home and Physician Practice Connections (PPC) programs. Application for recognition in these programs has strict requirements in the following areas:

    • Access and Communication
    • Patient tracking and registry functions
    • Care management
    • Patient self-management support
    • Electronic prescribing
    • Test tracking
    • Referral tracking
    • Performance reporting and improvement
    • Advanced electronic communications

Applications are made to and recognition is awarded by the NCQA. Many private and public health plans and employers are considering projects to recognize and compensate practices as PCMHs. Practices earning this PPC-PCMH recognition may be eligible for additional payment in the future. NCQA's Physician Recognition Programs have recognized nearly 10,000 physicians nationwide for excellence. The NCQA is broadly promoting practices and health plans that have attained recognition as PPC or PPC-PCMH practices.

For more information about Patient Centered Medical Home, visit www.ncqa.org or www.acponline.org or www.aafp.org.