Fact Sheet: Patient-Centered Medical Homes

NCQA’s Patient-Centered Medical Home (PCMH) Recognition program is a powerful tool for transforming primary care into what patients want it to be. That means:

• Patients have long-term partnerships with clinicians, not a series of sporadic, hurried visits.
• Clinician-led teams coordinate care, especially for prevention and chronic conditions.
• Medical homes coordinate other clinicians’ care and community resources, as needed.
• Patients have enhanced access through expanded hours and electronic communication.
• They help patients participate in decisions about their care to get better results.
• Medical homes coordinate care and improve quality but do not deny care; even so, many insurers pay modest fees for these benefits because they save more than they cost.

NCQA PCMH Recognition standards provide a roadmap for making this powerful change in how clinicians provide care. Clear, specific criteria show clinicians how to organize care around patients and work in teams to coordinate, track and improve care. We updated our PCMH standards in 2011 to be clearer, more specific and more challenging than our 2008 criteria. The new standards “raise the bar” in several important respects:

• They make medical homes more responsive to patients’ needs by incorporating surveys and other information to engage patients and families in quality improvement.
• They align with federal requirements for “meaningful use” of health IT.
• They emphasize language and culturally sensitive facets of care.
• They have a stronger focus on integrating care management and behavioral healthcare.
• They help pediatric practices by addressing such topics as parental decision-making, age-appropriate immunizations and teen privacy.

Different kinds of primary care practices can meet the standards, regardless of their size, configuration, electronic capabilities, populations served or location. NCQA’s three levels of PCMH recognition reflect how extensively practices meet our criteria. The different levels allow diverse practices to meet requirements and become what their patients want them to be.