NCQA Program to Evaluate Patient-Centered Medical Homes

PPC-PCMH(TM) to focus on care coordination, integration
WASHINGTON--(Business Wire)--The National Committee for Quality Assurance (NCQA) today launched
a new version of its Physician Practice Connections (PPC) program
designed to assess how medical practices are functioning as
patient-centered medical homes. The new Physician Practice Connections
- Patient-Centered Medical Home (PPC-PCMH(TM)) emphasizes the
systematic use of patient-centered, coordinated care management
processes.

The new standards are aligned with the joint principles of the
American Academy of Family Physicians (AAFP), the American Academy of
Pediatrics (AAP), the American College of Physicians (ACP) and the
American Osteopathic Association (AOA), which define the key
characteristics of the patient-centered medical home. NCQA worked
closely with the four medical specialty organizations and other
interested stakeholders to develop the PPC-PCMH and the specialty
societies have supported the standards as the tool to use to recognize
practices as medical homes in demonstration projects around the
country.

The medical home is a promising approach that seeks to strengthen
the patient-physician relationship by replacing episodic care with
coordinated care and a long-term healing relationship. The AAFP, AAP,
ACP, and AOA have defined the medical home as a model of care where
each patient has an ongoing relationship with a personal physician who
leads a team that takes collective responsibility for patient care.
The physician-led care team is responsible for providing all the
patient's health care needs and, when needed, coordinating care across
the health care system. A medical home also emphasizes enhanced care
through open scheduling, expanded hours and communication between
patients, physicians and staff. Many large health plans, as well as
Medicare and Medicaid, are planning demonstration projects to learn
more about how practices can become medical homes and the quality and
cost advantages of doing so.

"The Patient-Centered Medical Home has the potential to change the
interaction between patients and physicians from a series of episodic
office visits to an ongoing two-way relationship," said NCQA President
Margaret E. O'Kane. "Patients can no longer be silent partners in
their care - they are active participants in managing their health
with a shared goal of staying as healthy as possible."

"The Patient-Centered Medical Home offers the opportunity to
improve health care quality for all Americans," said John Tooker,
Executive Vice President and Chief Executive Officer of the American
College of Physicians. "Through the PPC-PCMH, NCQA is helping
physicians understand what functioning as a patient-centered medical
home means on a day-to-day basis for their practices and establishing
standards to recognize physicians who provide this type of care."

PPC-PCMH includes nine standards for medical practices to meet,
including use of patient self-management support, care coordination,
evidence-based guidelines for chronic conditions and performance
reporting and improvement. To be recognized as a patient-centered
medical home, practices will need to demonstrate the ability to
sufficiently meet the criteria of these standards (i.e. achieve a
minimum of 25 points out of 100 to attain the first of three levels of
recognition) and specifically pass at least five of the following 10
elements:

-- Written standards for patient access and patient communication

-- Use of data to show standards for patient access and
communication are met

-- Use of paper or electronic charting tools to organize clinical
information

-- Use of data to identify important diagnoses and conditions in
practice

-- Adoption and implementation of evidence-based guidelines for
three chronic conditions

-- Active patient self-management support

-- Systematic tracking of test results and identification of
abnormal results

-- Referral tracking, using a paper or electronic system

-- Clinical and/or service performance measurement, by physician
or across the practice

-- Performance reporting, by physician or across the practice

Large employers have also embraced the patient-centered medical
home concept. "The comprehensive and coordinated care that the medical
home promotes leads to better health, longer lives, higher patient
satisfaction and less expensive care," said Paul Grundy, chairman of
the Patient-Centered Primary Care Collaborative and IBM's Director of
Healthcare, Technology and Strategic Initiatives for IBM Global
Wellbeing Services and Health Benefits. "The question isn't whether we
should implement the medical home, but how. These standards clearly
assess and identify effective medical homes."

PPC-PCMH joins four NCQA programs designed to recognize excellence
in patient care in medical practices. Along with PPC, the programs
focus on caring for patients with diabetes, cardiovascular disease or
stroke, and back pain. For more information about all NCQA Recognition
programs, visit http://web.ncqa.org and click on "Recognition".

NCQA is a private, non-profit organization dedicated to improving
health care quality. NCQA accredits and certifies a wide range of
health care organizations and recognizes physicians in key clinical
areas. NCQA's Healthcare Effectiveness Data and Information Set
(HEDIS(R)) is the most widely used performance measurement tool in
health care. NCQA is committed to providing health care quality
information through the Web, media and data licensing agreements in
order to help consumers, employers and others make more informed
health care choices. For more information, visit http://www.ncqa.org/.

NCQA
Lauren Funk, 202-955-1705

Copyright Business Wire 2008