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What is PCMH?

Patient Center Medical Home or PCMH is a model designed to provide optimal, Patient-Centered primary care defined by a care planning process driven by a compassionate, robust partnership between Provider, Patient and the Patient’s family or care giver. The central concept is for the Primary Care Provider to coordinate all recommendable health care services including those delivered by other qualified Professionals for all stages of life; acute care, chronic care, preventive services and end of life care. Health Information Technology (HIT) and Health Information Exchange (HIE) will assist the Primary Care Provider in assuring that the patient receives the indicated care when and where they need and want it, in a culturally and linguistically appropriate manner across all venues of care.

In order to receive recognition as a Patient Centered Medical Home, a Provider or Provider Organization voluntarily participates in the evaluation process of an appropriate non-governmental entity to demonstrate that they provide Patient-Centered services as outlined by the recognizing organization. One such organization is the National Committee for Quality Assurance (NCQA).

NCQA established six (6) standards, characterized by a total of 27 elements, to define Patient-Centered Medical Home. These six elements are:

  1. Enhance Access and Continuity
  2. Identify and Manage Patient Populations
  3. Plan and Manage Care
  4. Provide Self-Care and Community Support
  5. Track and Coordinate Care
  6. Measure and Improve Performance

Out of the twenty-seven (27) total elements, six are must pass Elements required for any level of PCMH recognition. The must pass elements are:

  1. PCMH 1, Element A:  Access During Office Hours<
  2. PCMH 2, Element D:  Use Data for Population Management
  3. PCMH 3, Element C:  Care Management
  4. PCMH 4, Element A:  Support Self-Care Process
  5. PCMH 5, Element B:  Track Referrals and Follow-up
  6. PCMH 6, Element C:  Implement Continuous Quality Improvement

OKPCA created a crosswalk displaying the similarities between UDS, PCMH, and Meaningful Use that can be downloaded by clicking here. 

For more information about NCQA's version of PCHM click the link below.

PCMH and NCQA