For practices recognized under the National Committee for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) model, understanding and meeting the NCQA PCMH 2025 annual reporting requirements is critical to sustaining recognition.  NCQA continues to refine its NCQA PCMH standards and guidelines , emphasizing team structure, care continuity and data integrity. Here’s what your practice needs to do to stay compliant and ensure a smooth reporting process. This blog is a continuation of our piece back in July 2024, which listed three updates to NCQA PCMH's 2025 annual reporting requirements . What is NCQA PCMH?  The NCQA Patient-Centered Medical Home (PCMH) is a model of care that emphasizes care coordination, patient engagement and continuous quality improvement. The PCMH framework is designed to improve healthcare outcomes by fostering strong patient-provider relationships and enhancing team-based care.  Since its inception, the NCQA PCMH program has evolved to...

Preparing for a Patient-Centered Medical Home (PCMH) audit can seem daunting, but with the right approach, it doesn't have to be. This guide aims to demystify the process and offer practical advice for healthcare administrators, PCMH participants and medical practices. Focusing on DataGen's Medical Practice Consulting services , we'll show you how to streamline annual reporting to ensure core criteria are consistently met in your workflow, so you can focus on coordinated care management and quality improvement within your care team or healthcare system.  Understanding the PCMH audit  PCMH annual reporting is essential for maintaining the integrity, effectiveness and recognition for the National Committee for Quality Assurance’s (NCQA) PCMH model . Each year, practices submit requirements to renew their recognition, showcasing a small portion of documentation across six concept areas. However, a PCMH audit requires a more comprehensive review. About 5% of annual reporters ar...

*A newer piece is available on NCQA PCMH 2025 annual reporting standards and guidelines .  The National Committee for Quality Assurance (NCQA) consistently strives to enhance the quality of healthcare and improve patient outcomes. With the changing Patient-Centered Medical Home (PCMH) 2025 annual reporting requirements, it’s essential for healthcare professionals, providers and administrators to stay updated on the latest developments to enhance quality care and patient outcomes.  Here, DataGen’s Mandi Diamond, senior practice transformation advisor, covers the three biggest changes you need to know about for next year's annual PCMH reporting related to quality improvement worksheets, the importance of diverse patient examples in care management plans and enhanced communication protocols.    Let’s dive into the most important PCMH reporting requirement changes.   1. Re-introduction of the mini quality improvement worksheet  One significant update is th...

Health equity isn’t a one-size approach  The COVID-19 pandemic highlighted the crucial connection between Social Determinants of Health (SDOH) and patient outcomes. Addressing medical and behavioral health needs requires a comprehensive understanding of a patient’s social context.   Effective interventions and care plans must meet patients "where they are," and one-size-fits-all approaches fail to address diverse vulnerabilities and needs.  For healthcare organizations looking to begin or enhance their equity initiatives, the National Committee for Quality Assurance's (NCQA's) Health Equity Accreditation (HEA) is an excellent starting point. HEA is a comprehensive framework that aligns with many other recognized programs, such as those from the Joint Commission and CMS, providing a holistic approach to advancing health equity. It aims to improve the quality of care and patient experience within the United States.  3 Reasons why NCQA HEA is the perfect starting ...

The National Committee for Quality Assurance defines a patient-centered medical home (PCMH) as “a model of care that puts patients at the forefront.” The PCMH highlights the importance of care coordination and provides pathways to ensure that the medical neighborhood is tangible to the patients served.   The tenants of the medical home ask care teams to treat patients for their medical, behavioral and address their social and economic needs to achieve desired outcomes. As one of the 6 concept areas of the PCMH, it is imperative to implement policies, workflows and partnerships that will promote relationships outside of the primary care setting.   Medical homes are not just care settings but care connectors. Read on to learn:  how to sustain the medical home through effective care coordination;  why practices shouldn’t exclude community-based organizations; and  the key technical components for an effective, sustainable PCMH care coordination model.  Su...

First off, congratulations to you and your practice for achieving National Committee for Quality Assurance Patient-Centered Medical Home recognition! Gaining NCQA PCMH status is a big accomplishment for which you should be very proud. Now that you’ve completed the necessary steps to implement changes and earn recognition, you may be wondering what’s next. In this guide, we’ll navigate what to do next, PCMH standards and guidelines to follow and 2024 annual reporting requirements to focus on. Let’s get into it! What to do after earning NCQA PCMH recognition Before you’re ready to start earning the great benefits of PCMH recognition , you need to plan what actions you’ll take to maintain your status. Remember, PCMH is not a project, but a continual progression of the way care is delivered to patients, meeting them where they are. So, if you’re a practice that wishes to keep its PCMH, you’ll need to be accountable for each criterion you achieved when initially receiving PCMH recognition. ...

The National Committee for Quality Assurance’s Patient-Centered Medical Home model advances high-quality, cost-effective care, but practices must be vigilant to earn and maintain their PCMH Recognition. Staff members, technology tools and workflows can change, and practices need to adopt criteria from new standards and guidelines. Mandi Diamond, PCMH CCE, senior advisor of Practice Advancement Strategies at DataGen, offers five key capabilities to support PCMH Recognition. 1. Build a true team culture. Does everyone in the practice understand what they do and why? Is that understanding clear, and is it reinforced? Practice leadership may assume yes when the answer is often no. Diamond terms this “doing things TO a team versus WITH a team.” To avoid this: Share knowledge. A lone individual cannot be the sole source of expertise, and single points of failure create crises in teams. Disrupt silos. Ongoing communication delivered in multiple formats that bridge clinical and clerical team...