No. Shared appointments would not meet the requirement. Alternative appointments need to be offered through telephone or other technology-supported mechanisms.
PCMH 2017
FAQ Directory: Patient-Centered Medical Home (PCMH)
Filter Results
6.14.2018 AC 06 (Pediatric Specific)` If a pediatrician sees more than one child from the same family during one visit, does this meet the requirement for an alternative clinical encounter?
6.14.2018 CM 01D (Pediatric Specific) May practices use “limited or no family/caregiver support” as a social determinant of health?
Yes. For pediatric populations, practices may identify children and youth with special health care needs who are defined by the U.S. Department of Health and Human Services Maternal and Child Health Bureau as children “who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who require health and related services of a type or amount beyond that required generally.”
PCMH 2017
6.14.2018 TC 03 (Pediatric Specific) What are some examples of PCMH-oriented collaborative activities for pediatric practices?
6.14.2018 CM 01A (Pediatric Specific) Would temper tantrums as a behavioral health condition meet the intent of CM 01A?
Practices need to identify behavioral health-related criteria pertinent to their specific patient population such as a behavioral health diagnosis, substance use, a positive screening result from a standardized behavioral health screen, or psychiatric hospitalizations. If the practice feels that patients with temper tantrums is an identifier for patients in need of care management, the practice can use that defining criteria.
PCMH 2017
6.14.2018 KM 02E (Pediatric Specific) Would unhealthy behaviors associated with a parent’s behavior be acceptable for KM 02 E since they are responsible for preventing these behaviors?
Yes, unhealthy behaviors can be the result of parent behavior but ultimately, we're looking for the unhealthy behaviors demonstrated by the patient (child). Secondhand smoke may be a direct example of a parent’s behavior affecting the child’s health and poor oral hygiene may be a child’s unhealthy behavior, but could result from lack of parental oversight or health literacy.
PCMH 2017
6.14.2018 KM 12D (Pediatric Specific) Why would our practice recall pediatric patients, if not for preventive care, immunizations or acute/chronic care services? Give pediatric-specific examples.
5.29.2018 CC 04B How do practices document providing pertinent demographic and clinical information to a specialist if they use the same EHR?
Practices must provide a documented process for staff to follow to ensure that demographic and clinical data are available for the specialist, and either a report/log or an example showing that the process is followed (e.g., a screen shot of available information and how the information is made available to the specialist). If external referrals are made, the practice must specify the process for sharing information with those providers, as well.
PCMH 2017
5.29.2018 CC 10 (PP 04) Our practice has agreements with and shares patient records with behavioral healthcare providers, but we do not share the same EHR or physical location. Do we meet the requirement for integrating behavioral healthcare in our practice?
No. Although there is no requirement for a behavioral healthcare provider to be physically in the practice’s office, the behavioral healthcare provider must have at least partial access to the practice’s systems. Although the arrangements mentioned meet the intent of CC 09 (maintaining agreements with behavioral healthcare providers), they do not meet the requirements for this criterion.
If a practice site in an organization has integrated behavioral healthcare, the other sites in the organization may receive credit if there is also a process for their patients to access those behavioral healthcare services.
PCMH 2017
5.29.2018 QI 11 May practices focus on improving the number of patient experience survey responses it receives back from patients?
5.29.2018 QI 04A Are practices required to use the CAHPS PCMH survey to meet this requirement?
5.29.2018 QI 02B Are preventive care measures considered utilization measures?
5.29.2018 CC 08 Are practices required to only refer to specialists with whom they have agreements, or is the requirement that an agreement be in place? Give an example of an agreement.
Practices are not restricted to referring patients only to practices with whom they have established agreements. NCQA reviews at least one example of a formal or informal agreement with a subset of specialists, but does not expect practices to have agreements with all specialists to whom they refer patients. The goal is that expectations are outlined in the agreement, in addition to expectations of timeliness/content of response from specialists.
PCMH 2017