NCQA Releases Directory Highlighting Initiatives Supporting NCQA PCMH Recognition

July 28, 2016 · Amy Maciejowski

As the importance of patient-centered care continues to gain validity, there is a wealth of assistance for practices that want to transform their sites—and now, there is a central location for stakeholders to view every resource available to help in that transformation: NCQA’s Resource Directory of Incentives for NCQA Clinical Recognition Programs.

The directory links clinicians to local resources (financial and other) that support NCQA Recognition. The directory includes a list of public, private and multi-payer initiatives, by state, that support a variety of NCQA clinical recognition programs including: Patient Centered Medical Home (PCMH), Patient Centered Specialty Practice (PCSP), Patient Centered Connected Care, Diabetes Recognition Program (DRP) and the Heart/Stroke Recognition Program (HSRP).

Why Use the Directory?

The release of NCQA’s resource directory coincides with CMS’ anticipated announcement of states and regions selected to participate in the new Comprehensive Primary Care Plus (CPC Plus) program. NCQA supports CPC Plus, which offers an opportunity for practices to reduce burden and align with other payers and NCQA.

CPC Plus offers a unique opportunity to gain additional assistance for transforming primary care practices, stemming from a greater emphasis on quality care. The directory can be a tool for all states and regions, whether or not they participate in CPC Plus:

State/Region Selected to Participate in CPC

Your practice should apply—this is an opportunity to see financial rewards (especially from Medicare) for a commitment to primary care transformation. We encourage you to connect with other payers in your state or region because they might offer additional incentives or support, building on your investment and increasing the likelihood of sustained transformation. Refer to the directory for a list of organizations and initiatives providing support in your state or region.

State/Region Not Selected to Participate in CPC Plus

There are many resources available to support your investment in primary care transformation. Refer to the directory for a list of organizations and initiatives providing support in your state or region.

As Medicare prepares to support PCMHs more broadly with automatic credit in the new Merit-Based Incentive Payment System (MIPS), which adjusts clinician payment based on performance, there is a greater case for transforming into a PCMH. MIPS takes effect in 2019, but payment adjustments will be based on 2017 performance. Rules are not yet final, but will likely reward clinicians for being in NCQA-Recognized PCMHs during 2017.

Key Findings

• Almost 150 initiatives and organizations explicitly require or provide support for practices to attain and/or sustain NCQA PCMH Recognition.
• Although several initiatives and pilot programs concluded in 2015, new initiatives emerged in 2016.
• The increase in initiatives and organizations is primarily a result of NCQA’s comprehensive review of other organizations that support PCMH recognition (membership organizations, regional collaborative, regional extension centers, consultants).

View the 2016 Resource Directory of Incentives for NCQA Clinical Recognition Programs to find support in your area.