NCQA Expands the Medical Neighborhood

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NCQA Expands the Medical Neighborhood

Wednesday, July 29, 2015

The National Committee on Quality Assurance (NCQA) launched a new recognition program for practices that provide outpatient care or treat acute or episodic illness, but are not primary or specialty care providers. The new program, Patient-Centered Connected Care™ (PCCC), will allow retail clinics, onsite employee health clinics, urgent care centers, school-based clinics, physical therapy, podiatry, optometry, and chiropractic providers to increase communication and connection with primary care in order to fit into the medical home "neighborhood."

A goal of the PCCC program is to reduce health care delivery fragmentation by creating a Patient-Centered Medical Home-Neighborhood (PCMH-N) with a goal of achieving better patient care, lowering costs and allowing for more integrated care. This occurs when specialists interact with primary care practices, and may be achieved when facilities (clinics, centers, etc.) engage in processes that ensure effective communication, coordinate and integrate with PCMH practices, and produce timely consultations and referrals.

Health care facilities that want to become recognized by the NCQA in the PCCC program must meet a minimum score across five different standards, with a total of 24 capabilities.

The five PCCC standards focus on the following elements for health care facilities:

  • Connecting with primary care: connects with and shares information with primary care providers
  • Identifying patient needs: directs patients to appropriate providers, when necessary
  • Patient care and support: uses evidence-based decision support in care delivery, collaborates with patients to make care decisions and delivers culturally and linguistically appropriate services
  • System capabilities: uses electronic systems to collect data and execute tasks
  • Measure and improve performance: monitors performance and carries out activities to improve clinical outcomes and patient experience

Practices complete a survey tool and submit documentation to NCQA showing that they adhered to the standards. Recognition is valid for three years

The standards for NCQA's PCCC program differ from the PCMH recognition program for primary care practices and from the Patient-Centered Specialty Practice (PCSP) recognition program for specialty care practices. Specialists who are eligible for the PCSP program are those represented by the American Board of Medical Specialties and Behavioral/Mental Health providers.

Differences include the PCMH program for primary care providers and the PCSP program for specialists both have six standards while the PCCC program only has five standards. Plus, the PCMH and PCSP program allow for three levels of recognition while the PCCC program is simply a pass or fail. For more information on the PCCC program, please click here.

 

Information is provided by Medical Advantage Group, a leading health care consulting and management company. Check out www.medicaladvantagegroup.com for more information.