PCMH – To be certified or not?

Primary care practices have been given the added responsibility of coordinating advanced patient care with physicians, to ensure quality care is delivered, where and when required. More than 10% primary care practices have been recognized as Patient Centered Medical Homes or PCMHs. These would bridge the gap between treatment and coordination.

There are some great benefits which PCMHs bring, and they eventually help to improve access to medical care and health outcomes for patients.

Here is an overview of what a PCMH offers

PCMH benefits

Many primary healthcare centers are vying towards being certified as a PCMH, and the newer regulations have been giving them all the more reason to head in that direction. There are many programs where the government requires primary care practices to perform similar functions as a PCMH. Here is a list of some Primary Care Innovations and PCMH programs.

If PCMHs get recognized in the Expanded Medical Homes model, then they would get 5% Medicare FFS Bonus and also exemption from MIPS adjustments.

The EHR role in PCMHs

NCQA has translated the original PCMH concept into measurable activities and the definition has created 6 standards which will be used to score the practice.

The pre-validation program from NCQA is for EHR vendors, advanced registries, population management systems and other technology solutions which fully meet 1 or more requirements set forth. A practice using a pre-validated system awarded auto credit is eligible for automatic credit for those factors, which saves time and money for the administrative side.

How to go about pre-validation?

NCQA Prevalidation for PCMH
If you are an HIT provider catering to primary care centers, you should be exploring the PCMH option. There is a need for well thought out, patient focused solutions which will help these PCMHs perform their coordinating duties efficiently.

Some of the folks here are really keen on understanding this space, and they spent a large chunk of time researching the regulations. Here is more on PCMH.

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Nagendra Prasad

Prasad is a passionate healthcare technologist who has had the opportunity to design several healthcare solutions from a security perspective to satisfy regulatory compliance. He has been leading engineering initiatives for several US EHR vendors.

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