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 ...

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...

To build a better medical practice, you must transform and then sustain the change. Through customized engagements and best practice experience, Practice Advancement Strategies guides clinical teams through the following challenges and opportunities: staff shortages/burnout; practice culture; payer negotiation and contracting; and value-based care outcomes These will be hot topics at the next Medical Group Management Association event: the Medical Practice Excellence: Financial and Operations Conference , just around the corner in Orlando, March 19-21. To help you prepare — for the conference or progress in general — DataGen Practice Advancement Strategies offers the following insider tips for practice advancement. 1.   Transformed teams can transform patient care. Research shows that earning Patient-Centered Medical Home Recognition from the National Committee for Quality Assurance can reduce staff burnout by more than 20%. While workforce shortages clearly impact burnout, c...

Achieving Patient-Centered Medical Home recognition sets your practice apart from others as you focus on the quadruple aim: continual improvement of outcomes, decreased expenditures and increased patient and staff satisfaction. PCMH adopts repeatable processes, policies, communication, documentation and reporting, which is ─ the backbone of value-based incentive programs and payer initiatives nationwide. Using a team approach to best understand patient populations and meet patients where they are leads to more equitable healthcare across all patient populations. To keep the benefits of PCMH recognition, practices must keep their medical homes current and sustain the program from year to year. Sites must demonstrate in Q-PASS (the National Committee for Quality Assurance’s web-based evaluation tool) that their medical home workflows are in place by their stated reporting date. NCQA updated the PCMH standards, guidelines and annual reporting requirements for 2023. Standards and Guideline...

The National Committee for Quality Assurance (NCQA) releases updates annually to the Patient-Centered Medical Home (PCMH) Standards and Guidelines. Any primary care practice, whether first transforming to achieve PCMH recognition, or a practice seeking to maintain recognition, must implement and demonstrate the core criteria of the PCMH standards and guidelines. NCQA has added numerous elective criteria for practices to pursue to ensure they have an adequate amount of credits to achieve recognition between the mandatory core and elective criteria available. Practices should visit the NCQA website for the latest version (v8) of the standards and guidelines , released on July 1, 2022. Health equity An update made this year is to best align with the Health Equity Accreditation/Plus program offered by NCQA. Also, in response to lessons learned from the COVID-19 pandemic, PCMHs should be positioned to understand what vulnerabilities and social determinants may impact their patients...