DENVER – The National Committee for Quality Assurance has improved its patient-centered medical home recognition process, making application submissions over the Web easier and decision times quicker, according to Patricia Barrett, the group's vice president for product development.
Since NCQA launched its recognition program about 2½ years ago, there have been complaints that the process is too cumbersome.
In September, the American Academy of Family Physicians' Congress of Delegates even passed a resolution calling for simpler assessment and documentation tools, and increased transparency and feedback.
“We have heard the criticism,” said Ms. Barrett. “We want the difficulty to be in becoming a medical home, not in applying” for recognition.
NCQA has hired additional staff to answer questions and provide feedback, she noted, and has updated its Web portal to make it more user friendly.
Applicants aren't required to mail or e-mail their applications anymore; they can be filled out directly on the Web site.
In addition, applicants can upload larger documents, and uploads are quicker, with documents appearing almost simultaneously at NCQA headquarters. The group now accepts electronic signatures on legal documents, Ms. Barrett said.
NCQA also has streamlined its document requirements to cut down on redundancy, she noted. And those renewing their recognitions don't have to start from scratch – document requirements have been eased for renewals.
In short, “We are meeting our target now” for 60-day decisions on recognition, Ms. Barrett said.
The changes sound good to Dr. Mary Campagnolo, a family physician in Lumberton, N.J., and a member of the state delegation that submitted the resolution at the Congress of Delegates.
The problem has been with the process, not the standards themselves, she said. Doctors at the AAFP meeting agree that the standards need to be rigorous in order to be meaningful, Dr. Campagnolo explained. “The documentation is voluminous,” she noted, adding that quicker uploads and other changes should reduce some of the hassle.
Many of the improvements are already in place just in time for NCQA's release of updated PCMH standards early next year.
Though the process is a bit easier, the standards will be tougher. “It will be a more rigorous program,” Ms. Barrett said. “We raised the bar significantly.” That's in part because NCQA has a better idea of what payers are likely to require for practices to qualify for additional reimbursements as medical homes, she said.
So far, NCQA has recognized about 1,000 PCMHs, and is fielding about 100 PCMH recognition applications per month.
The new standards haven't been finalized, however, so the group was short on details about the changes. But, in general, there will be greater emphasis on the full scope of a patient's health needs – reducing obesity, quitting smoking, and the like – not simply managing the problem that brought her into the clinic.
There also will be more emphasis on coordinating care with other practices, and ensuring records of what's done elsewhere make their way back to the medical home. In addition, meaningful use requirements have been added to electronic health records standards.
Scoring will get tougher, too. For instance, to achieve level 1 PCMH status, practices may have to earn 35 points on the group's 100-point scale – up from 25 under the current system.
The price – currently $1,280 for a three-physician practice, for example – is going up, too, though NCQA isn't certain yet how much. NCQA typically adjusts its program prices every other year, a spokeswoman said.
The changes to NCQA's program come as the Joint Commission and the Utilization Review Accreditation Commission both prepare to launch their own PCMH recognition programs next year.