What is NCQA PCMH?

What is NCQA PCMH?

NCQA’s Patient-Centered Medical Home (PCMH) Recognition program was developed to identify medical practices that have invested in a model of care that puts patients at the forefront and where continuous quality improvement is a priority.

What are key elements of Pcmh?

5 Key Functions of the Medical Home

• Comprehensive Care. The PCMH is designed to meet the majority of a patient’s physical and mental health care needs through a team-based approach to care.
• Patient-Centered Care. The PCMH delivers primary care that is oriented towards the whole person.
• Coordinated Care.
• Quality & Safety.

Which Pcmh standard focuses on 24/7 access to patient and their families?

Patient-centered Access and Continuity (AC) – the PCMH model expects continuity of care. Patients/families/caregivers have 24/7 access to clinical advice and appropriate care facilitated by their designated clinician/care team and supported by access to their medical record.

What are the five core functions of Pcmh?

The PCMH model is committed to providing safe, high-quality care through clinical decision-support tools, evidence-based care, shared decision-making, performance measurement, and population health management.

What does it mean to be NCQA accredited?

For employers—whether they are self-insured or fully insured—NCQA Accreditation means that an independent, nationally recognized organization has validated a plan’s performance. Without NCQA Accreditation, there is no assurance for employers that a health plan is truly committed to meeting quality standards.

What are the 5 domains of HEDIS?

HEDIS and Performance Measurement

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures Reported Using Electronic Clinical Data Systems.

What is the purpose of Pcmh?

The primary care medical home is accountable for meeting the large majority of each patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care. Providing comprehensive care requires a team of care providers.

How does a Pcmh work?

The Patient-Centered Medical Home (PCMH) is a care delivery model whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand.

What is the goal of PCMH?

The goal of the PCMH model is to provide safe, high-quality, affordable, and accessible patient-centered care by promoting stronger relationships with patients, addressing care needs more comprehensively, and providing time to coordinate care across all sectors of the healthcare system.

What are the standards of NCQA?

NCQA standards are a roadmap for improvement—organizations use them to perform a gap analysis and align improvement activities with areas that are most important to states and employers, such as network adequacy and consumer protection. Standards evaluate plans on: Quality Management and Improvement.

How do I get NCQA accreditation?

Process: Becoming Licensed

1. Request an application. Submit an inquiry through My NCQA.
2. Review Handbook and Application. NCQA will send you the handbook and application.
3. Submit the Application and Pay the Application Fee.
4. NCQA Reviews the Application.
5. Pay the Final Fee and Earn Your License.
6. Maintain Your License.