This blog post was written by our guest author Susan Maxsween, Director of Healthcare – Practice Transformation. You can connect with her on LinkedIn by clicking here.

The National Committee for Quality Assurance (NCQA) has announced that they will be launching new Patient Centered Medical Home (PCMH) standards on March 31, 2014.  These standards, yet to be named, will replace the existing PCMH 2011 standards.

NCQA to Launch New PCMH Standards

The launch of the new standards will further enhance the core components of the PCMH model and include:

  • Alignment with Meaningful Use Stage 2
  • Enhanced emphasis on team-based care with the patient as part of the care team
  • Further focus on care-management and self-care support of high-need patient populations
  • Focus on defined criteria for care planning including social determinants of health, behavioral health, cost/utilization, poorly controlled and complex conditions and the unique needs of patients referred by specialists or other outside entities.
  • Quality improvement activities must show practices are trying to improve in all three areas of the triple aim including patient experience, cost and clinical quality.
  • Quality improvement efforts must occur at least annually and NCQA may choose to audit for this requirement

If you are currently considering achieving PCMH recognition under the 2011 standards, you must act quickly before the standards expire.  All survey tools for PCMH 2011 must be purchased by June 30, 2014 and all documentation must be submitted by March 31, 2015.  It is suggested that multi-site corporate survey tools be submitted no later than December 31, 2014.

The journey to PCMH recognition continues to be an engaging and enlightening transformation process.  This evolving process continues to support and enhance focus on the patient centered approach to delivery and management of patient care.

If you are a practice that has gone through the recognition journey, you know all too well the long-term benefits that your practice receives when going through this process.   If this is your first introduction to the PCMH model, welcome aboard.

In a recent blog, RMS Healthcare discussed the evolution of healthcare and the impending changes in overall healthcare delivery and how practices need to position themselves to be prepared and manage the change.  Without a question, it is evident that being a PCMH practice will position you very well.

With the launch of the new standards and seeing an ever-growing reference to the PCMH model, you may begin to raise questions, such as: Are you a key stakeholder in a primary care physician practice or organization?  Have you long been considering becoming a patient centered medical home?   With the key changes in the new standards making the recognition harder to achieve, this may be the year that you are ready to move forward with your goals.

RMS Healthcare, a division of Research and Marketing Strategies, Inc. (RMS) focuses on optimizing relationships with its healthcare clients.  With a dedicated team of healthcare consultants, RMS Healthcare offers targeted healthcare consulting and research services directed to the specialized needs of our healthcare clients in their practice transformation journey.

RMS Healthcare operates as an extension of our clients’ business in providing operational support functions.  We work in tandem with our clients, developing customized work plans to ensure successful achievement of operational goals while maximizing use of technology as well as guidance and assisting in achieving operational goals to achieving Patient Centered Medical Home (PCMH) recognition. Our team works with hospitals, health-related facilities and primary and specialty care practices.  Our firm understands that from a business perspective, transformation must focus on delivery of quality driven patient centered care, while also focusing on managing overall administrative expenses and increasing practice revenue.

RMS Healthcare has over 50 years of collective and proven experience in healthcare practice transformation, staff training and development, strategic planning, business plan development and patient experience measurement specific to the healthcare industry. Our compliment of clients includes physician practices, healthcare delivery systems, hospitals, physician organizations and community healthcare organizations.  We have assisted over 100 practices in their transformation journey to become a recognized Patient Centered Medical Home.

RMS Healthcare can help you transform your practice, allowing you to take advantage of current and future financial incentives.  We have successfully assisted primary care physician practices in achieving recognition through NCQA and are pleased to share this update with you.  If you are interested in learning more about how we can help your practice, please contact Susan Maxsween, Director of Healthcare and Practice Transformation at SusanM@rmsresults.com or telephone her at 1-866-567-5422.