This blog post was written by our guest blogger Karen Joncas, Healthcare Transformation Coordinator at Research & Marketing Strategies (RMS).

NCQA Releases Updated PCMH Standards for 2014

NCQA Releases Updated PCMH Standards for 2014

In a recent blog posted in February of 2014, RMS Healthcare announced that National Committee for Quality Assurance (NCQA) would be releasing updated Patient Centered Medical Home (PCMH) standards in March. On Monday, March 24th, NCQA launched the updated NCQA PCMH standards, entitled PCMH 2014.  The updated recognition program builds on the successful foundation of the 2011 standards and enhances the core components of the Patient-Centered Medical Home model to now include:

  • 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.
  • Validation of sustained transformation requiring practices to show long-term compliance with NCQA standards over a long period of time.
  • 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.
  • Evidence that Quality improvement efforts are occurring at least annually.
  • Continued evidence of alignment with Meaningful Use Stage 2

To view these new standards from click here.

In a recent webinar, hosted by NCQA, they reviewed the new standards and stressed the importance of sustainability of the patient-centered delivery model and how the new standards reflect this commitment.  With the need to show improvement from additional quality initiatives over a longer period of time, the new standards will be more difficult to achieve for those practices new to the patient-centered model of care. If you are considering seeking recognition this year, we suggest that you act quickly before the PCMH 2011 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.

There is no question that healthcare delivery is evolving and practices need to position themselves for the change. Payment reform is underway in the public sector with current bills in Congress changing the way providers are reimbursed for patient care.  In the future, payments to providers will be based on the value of services provided, getting away from old formulas which were heavily weighted to episodic care.  Without a question, it is evident that being a patient-centered medical home will position you very well for any future incentives.  If you are new to understanding the PCMH concept and its value, NCQA also recently launched a white paper entitled, The Future of Patient-Centered Medical Homes Foundation for a Better Health Care System.  The white paper speaks to the power of PCMH in improving quality, cost and experience of primary care, and also recognizes that this is just the foundation of work underway that is being done in the broad sense of changing the landscape of our healthcare delivery system.

If you would like to join the 7,066 NCQA Recognized Patient Centered Medical Homes, RMS Healthcare can help you transform your practice, allowing you to take advantage of current and future financial incentives

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. We can help you with these new 2014 PCMH standards.

If you are interested in learning more, please contact Susan Maxsween, Director of Healthcare and Practice Transformation at or telephone her at 1-866-567-5422.