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10 tips for achieving Patient-Centered Medical Home (PCMH) certification

While primary care physicians always put patients first, their focus is intensifying as the healthcare industry makes the seismic shift to value-based care.

The National Committee for Quality Assurance (NCQA) is one of a number of organizations that support the recognition of Patient-Centered Medical Homes (PCMH) through a formal program. It aims to improve primary care by using standards that describe clear and specific criteria, which help practices organize care around patients, work in teams and track progress over time.

Most everyone agrees that these are laudable goals. But the certification process strikes fear in the hearts of many well-intentioned practices.

According to those who have achieved NCQA’s highest certification (Level 3), it may be easier than you think. Two experts — Barbara Johnson, nursing director at Elmwood Health Center in New York, and Deb Donovan, operations director at Derry Medical Center in New Hampshire – share these helpful tips with NCQA/PCMH applicants:

1.       Remain calm. The certification process is not as complicated as it looks. You will probably find you are already doing many of the required processes, and these are strengths you can build on.

2.       Read the entire survey before you start. Focus on the “must pass” elements of the survey first.

3.       Involve your whole team from the beginning. Not everyone needs to be directly involved with completing the assessment, but everyone needs to support it. Explain to all staff how these standards help improve patient care and the financial health of the practice.

4.       Phrase your questions with “How” instead of “If.” When clarifying problems for your practice to solve, engage your teams by focusing on how you will achieve goals, instead of whether or not you will attempt the goal.

5.       Stay organized. Print out the survey, divide up the work and note who needs to help with each section. You can keep track of responses on the master copy. To help keep track of all the documentation, name each file to correspond with the question it supports in the survey.

6.       Be prepared to change your workflow and job descriptions. While Barbara and Deb did not have to hire new staff to accomplish certification, they advise you might have to do things a little differently. Be open to change.

7.       Use screen shots to document your processes. When elements require reports, often a screen shot of your software will suffice. Just be sure to remove all patient names. And remember you are able to link one document to multiple elements.

8.       Get to the intent of standards. NCQA is not looking for cookie-cutter responses to the survey. Instead, it wants to know what your process is, and how you know it is working. Processes can be different as long as you’re getting to the right outcome.

9.       Don’t overthink it. NCQA has a lot of applications to read, so keep your responses simple and direct. NCQA can always follow up if they need more information.

10.   Ask for help. NCQA responds quickly to questions. Reps can explain in detail what they are looking for in each element. You can find contact information on the NCQA website.

Editor’s Note: Jim derived the content of this post from a webinar available only to Allscripts Regional User Groups.  It is one of the many resources available to these groups, to help clients network with one another as part of the Connected Community of HealthTM. For more information visit the ARUG Directory on ClientConnect.

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