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Your Questions Answered: Patient-Centered Medical Homes

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The concept of a “medical home” goes back as far as the late 1960s, when the American Academy of Pediatrics (AAP) introduced it to advocate for better care coordination for children with special needs. It wasn’t until 2007, though, that the entire U.S. healthcare community began to fully latch onto it.

The Patient Centered Medical Home (PCMH) isn’t really a “home” in the physical sense. Instead, it refers to a collaborative care model that endorses the use of technology-enabled health information exchange to facilitate partnerships between patients, their providers, and even their families. The PCMH model is endorsed by many different organizations and is constantly evolving—which of course leads to lots of questions.

Here are some answers to a few questions asked during our recent webinar, Unlocking the Benefits of Patient-Centered Medical Homes, led Elizabeth Woodcock, MBA, FACMPE,CPC:

What are the four organizations that offer PCMH certification?

The National Committee for Quality Assurance (NCQA), The Joint Commission, the Accreditation Association for Ambulatory Health Care (AAAHC) and URAC all have “medical home” programs. The NCQA’s program is the most widely recognized.

How can my practice get a list of what we need to do to reach each level of Patient-Centered Medical Home recognition from NCQA?

There are many good online resources, and the NCQA website has a great section about how to become a PCMH. Once you get a good grasp of what you’ll need to do, you should make a checklist of priority items to make sure you meet all of the standards in the right order.

Do we need to have an electronic health record (EHR) to be a PCMH?

For Level 1 NCQA Recognition, your practice does not need an EHR. However, some other organizations and even payers that have initiated PCMH programs may indeed require an EHR. These organizations typically have their own requirements—make sure you check with each of these organizations to ensure your practice has the necessary technology in place.

What types of investments might my practice need to make to become a PCMH?

Practices usually find that there is a time investment for the basic application process itself, which typically takes three to six months. This process includes gathering policies and screenshots of current technology processes.  In terms of infrastructure investment, the most common one is a nurse. Sometimes an existing phone/triage nurse will be able to dedicate time to the process for perhaps an extra three to five hours a week. Others, however, find they must hire a new part- or full-time nurse. Like most changes, it just depends on the size of your practice and your current workflow processes.

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