The NCQA Medical Home is a voluntary recognition program for physician practices that provide a medical “home,” or coordinating point, for their patients. Building on the joint principles developed by the primary care specialty societies (American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics and American Osteopathic Association), the NCQA Medical Home standards assess whether the practices are functioning as medical homes.

The standards require documentation and measurement of the practice’s ability to strengthen the physician-patient relationship by promoting improved access, coordinated care, and enhanced patient/family engagement.


What can NCQA Patient-Centered Medical Home (PCMH) Recognition do for you?

  • The Medical Home concept has been associated with improved quality, equity and staff/provider satisfaction and has the potential to reduce overall health care costs
  • PCMH Recognition can allow a practice to benefit from health plan incentives
  • Numerous plans and more than 30 states have launched projects to recognize physician practices as medical homes. Some plans may:
    • pay rewards for achieving recognition;
    • supplement application fees for recognized physician practices;
    • identify top quality physicians in provider directories with recognition seals;
    • support data collection efforts necessary for recognition and required for entry into high-performance (preferred physician) networks.
  • PCMH recognition can improve Medicaid reimbursement for patient services. Several State Medicaid programs have begun to make additional payments if the practice is Recognized by NCQA
  • PCMH recognition may help attract new business, as well as help maintain or strengthen your status as a recognized leader among your peers


What can PSN provide?

  • Consultation and training to help you understand the standards;
  • Assessment of documentation compliance to NCQA standards;
  • Development of policies and templates to meet the standards;
  • Gap analysis – we can tell you what’s missing from your documentation;
  • Preparation assistance with NCQA’s Interactive Survey System application;
  • File audits;
  • Program design.

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