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Oncology Medical Home Recognition

Oncology practices have a unique relationship with patients: they take on the principal long-term care of patients in active cancer treatment. That’s why NCQA developed the Oncology Medical Home Recognition program for oncology practices, built on the patient-centered medical home (PCMH) model.

The PCMH model puts patients first. It emphasizes team-based care, effective communication and coordination, and helps build relationships between patients and their clinical care teams. The NCQA PCMH Recognition program is the most widely adopted medical home model in the country—more than 12,000 primary care practices are recognized and more than 60,000 clinicians are in recognized practices.

What is NCQA Recognition?

NCQA Recognition programs are developed from evidence-based standards and guidelines. Practices download these standards, review them, perform a gap analysis and apply the standards based on their practice needs. After transforming their practice, they use NCQA’s survey tool to submit evidence to NCQA that they meet the standards. Practices that meet the standards earn recognition status and can display the NCQA seal.

What’s in the Oncology Medical Home program?

Oncology Medical Home Recognition evolved from NCQA’s Patient-Centered Specialty Practice (PCSP) Recognition program, which helps facilitate team-based care by recognizing specialists who use the PCMH model to improve collaboration and health care delivery.

The PCSP standards—which include emphases on team-based care, care coordination, care management and population health—are the foundation of Oncology Medical Home Recognition. Although oncology practices can earn PCSP Recognition, the Oncology Medical Home program addresses the extra steps involved in using a patient-centered approach to treat patients with cancer.

Practices that earn Oncology Medical Home Recognition also earn a PCSP seal.

Specialty Practice Standards

  • Track and Coordinate Referrals. The practice coordinates with primary care and referring clinicians to ensure timely exchange of information.
  • Provide Access and Communication. The practice provides timely access to culturally and linguistically appropriate clinical advice and care.
  • Identify and Coordinate Patient Populations. The practice systematically records patient information for patient populations and uses it to coordinate patient care.
  • Plan and Manage Care. The practice collaborates with referring clinicians and the patient/family/ caregiver to plan and manage care and to enable patient self-care.
  • Track and Coordinate Care. The practice systematically tracks tests and referrals to coordinate care with subspecialists and facilities.
  • Measure and Improve Performance. The practice systematically monitors its performance and carries out activities to improve clinical outcomes, efficiency and patient experience.

Oncology-Specific Elements

  • Quality Improvement. The practice monitors at least six standardized oncology quality measures.
  • Oncology Practice Responsibilities. The practice orients patients and their families/caregivers, explains patient and practice responsibilities, discusses available services and care coordination and instructs patients/families/caregivers how to obtain clinical advice 24/7.
  • Comprehensive Health Assessment. The practice has a process for comprehensive health assessment in relevant areas. 
  • Evidence-based Pathways. The practice adopts diagnostic and therapeutic, evidence-based pathways and pathways for symptom management.
  • Coordinating Patient-Centered Support During Treatment. The practice works with specialists, consultants, community partners and others in the patient care team to ensure appropriate support.
  • View the Oncology Medical Home Standards recorded training here.

Get Started with Oncology Medical Home Recognition (Initial or Renewal Surveys)

  • Download the Oncology Medical Home (PCMH-O) Recognition Standards & Guidelines
  • Order the online application and complete the eligibility check.
    • If you are a multi-site and/or multi-specialty organization, please DO NOT proceed to the following steps until you have requested and participated in an eligibility call with NCQA and received approval.
  • Learn standards and transform your practice.
  • Purchase the survey tool.
  • Submit the application and payment.
  • An NCQA Representative will connect with you and guide you through your recognition process, including scheduling your virtual check-ins.
  • Participate in virtual check-ins with an NCQA Reviewer.
  • Submit your completed survey.
  • Earn recognition!

What if I’m Already an NCQA-Recognized PCSP Practice?

If you’ve already earned NCQA PCSP Recognition, you can still earn Oncology Medical Home Recognition by completing an Add-On Survey.

  • Request an Add-On Survey through the Recognition Program Application Portal
  • NCQA notifies you when the survey tool is available for use. 
  • An NCQA Representative will connect with you and guide you through your recognition process, including scheduling your virtual check-ins.
  • Participate in virtual check-ins with an NCQA reviwer.
  • NCQA notifies you of your new Oncology Medical Home recognition status!

PCSP 2016 & Oncology Medical Home (PCMH-O) Documentation for Multi-site Organizations

There are four elements in the Oncology Medical Home Recognition Program for which a multi-site organization can share evidence: 

  • Element C: Oncology Practice Responsibilities 
  • Element D: Comprehensive Health Assessment 
  • Element E: Evidence-Based Pathways 
  • Element F: Coordinating Patient-Centered Support During Treatment 

The evidence of these elements can be demonstrated to the reviewer one time for credit across all practice sites in the organization pursuing recognition.

For details regarding elements in PCSP 2016 that can be shared, please view the following resources: 

The Recognition Review Process

After you submit your application and commit to the recognition process, an NCQA representative will contact you to introduce themselves via email and to setup an orientation call. Prior to the orientation call, the practice will be asked to complete the “Practice Information” section of the Organizational Background to provide some information about the practice, including its systems, demographics and participation in initiatives. This information will help to inform the orientation call with the NCQA representative.  

During the orientation call, your NCQA representative will describe the recognition and virtual check-in process, review the results of your questionnaire and identify any opportunities for the practice to use auto-credit for HIT vendor prevalidation

Multi-site organizations will purchase a survey tool for each practice site within its organization. The practice will identify a primary site and use that site’s survey tool to respond to and provide evidence for all selected corporate eligible elements.

Need detailed instructions on our RP Application Portal? If so, please use our step-by-step guide for Oncology Medical Homes

Pricing

Pricing for Oncology Medical Home Recognition is the same as pricing for PCSP Recognition. If you are an oncology practice that has achieved PCSP Level 2 or 3 Recognition, the fee will be the current add-on fee. See pricing.

Are you interested in Oncology Medical Home Recognition? Contact us today and an NCQA representative will be in touch.

Current customer? If you are a current NCQA customer and have a question, contact us through the My NCQA portal.