Presented by
Candace J. Chitty
RN, MBA, CPHQ, PCMH-CCE
 What is this document?
 Where does it come from?
 Who creates its?
 How do I use it?
 Where can I find it?
 When wi...
http://www.ncqa.org/portals/0/programs
/recognition/PCMH_2011_Changes-
Clarifications_11-16-12.pdf
Eligibility
Policy & Procedures Section 1: PCMH 2011
Eligibility and the Application Process: &
Explanation of Standard1D
...
N/A Responses
1A factor 3
1B factor 4
2B factor 3
6F factors 3 & 4
Added to explanation
“The practice must provide a writt...
Meaningful Use
› 3C factor 5
 Flagged as Core Meaningful Use Criteria 13
› 5C factor 5
 Flagged as Core Meaningful Use C...
Standard 4B
 Changed documentation for factor 2 “The
practice has a log or report showing referral
tracking to the commun...
Standard 5B
 Changed documentation for factors 1-3 “The
practice provides a documented process or
procedure and a report,...
Standard 6A
Added to explanation for factor 1 “Preventive
measures should encompass a practice’s entire
population and not...
Standard 6F
 Changed explanation for factor 1: Removed
“Reporting by attestation is required in 2011:
electronic reportin...
Appendix 2
 Add to 3C “Core Requirement 13: Provide clinical
summaries for patients for each office visit. Clinical
summa...
These changes and clarifications are
effective beginning March 26, 2013.
NCQA provides updates bi-annually.
Thank you for participating in today’s
webinar. Please don’t hesitate to
contact us with any additional
questions or for i...
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PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates
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PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates

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Clarifications and updates to NCQA's 2011 PCMH standards

Our speaker Candace J. Chitty, BSN, MBA, CPHQ, PCMH-CCE is a NCQA PCMH reviewer and an expert in the NCQA patient centered medical home model and recognition process

Published in: Healthcare, Technology, Business
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PolicyPLUS Webinar - NCQA's 2011 PCMH standards, policy and clarification updates

  1. 1. Presented by Candace J. Chitty RN, MBA, CPHQ, PCMH-CCE
  2. 2.  What is this document?  Where does it come from?  Who creates its?  How do I use it?  Where can I find it?  When will the next one be issued?  When are the clarification and changes effective?
  3. 3. http://www.ncqa.org/portals/0/programs /recognition/PCMH_2011_Changes- Clarifications_11-16-12.pdf
  4. 4. Eligibility Policy & Procedures Section 1: PCMH 2011 Eligibility and the Application Process: & Explanation of Standard1D › “The practice may define a Personal Clinician as a residency group under a supervising clinician, although residents are not identified individually for selection as a personal clinician. The practice may define a Personal Clinician as a combination of a physician and a nurse practitioner or physician assistant who share a panel of patients. These clinicians will be identified individually with the Recognized practice. › Only the “Supervising Clinician” is identified as part of the Recognition
  5. 5. N/A Responses 1A factor 3 1B factor 4 2B factor 3 6F factors 3 & 4 Added to explanation “The practice must provide a written explanation for an NA response.”
  6. 6. Meaningful Use › 3C factor 5  Flagged as Core Meaningful Use Criteria 13 › 5C factor 5  Flagged as Core Meaningful Use Criteria 14 › 5B factor 6 & 5C factor 7  Removed “To qualify for Meaningful Use, the practice must meet the related factors using a certified EHR” in documentation. (It is a duplication of what is in the explanation)
  7. 7. Standard 4B  Changed documentation for factor 2 “The practice has a log or report showing referral tracking to the community service resources used in PCMH 4B, factor 1 over a minimum period of one month.”  Changed documentation for factor 3-4 “The practice has a documented process, evidenced by at least three examples.”
  8. 8. Standard 5B  Changed documentation for factors 1-3 “The practice provides a documented process or procedure and a report, log or other means of demonstrating that its process is followed. A paper log or screen shot showing electronic capabilities is acceptable.”  Removed from explanation of factor 2 “Screen shots of a patient record do not meet the requirement.”
  9. 9. Standard 6A Added to explanation for factor 1 “Preventive measures should encompass a practice’s entire population and not limited to specific measures for a patient population with chronic conditions within the practice. The intent of preventive measures are for practices to develop activities to improve quality of care for all patients in the practice (Factor 2 will focus on the chronic condition populations). Preventive measures include: 1)…”
  10. 10. Standard 6F  Changed explanation for factor 1: Removed “Reporting by attestation is required in 2011: electronic reporting is required in 2012.”  Changed documentation for factors 1 and 2: “Factor 1: The practice provides reports of clinical quality measures. Demonstration of transmission is required when implemented by CMS or states. Factor 2: The practice provides reports demonstrating electronic data transmission to other entities and public health agencies.”
  11. 11. Appendix 2  Add to 3C “Core Requirement 13: Provide clinical summaries for patients for each office visit. Clinical summaries provided to patients for more than 50% of all office visits within 4 business days. Exclusion: Any EP who has no office visits during the EHR reporting period.”  Add to 5C “Core Requirement 14: Capability to exchange key clinical information (for example, problem list, medication list, allergies, diagnostic test results), among providers of care and patient authorized entities electronically. Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.”
  12. 12. These changes and clarifications are effective beginning March 26, 2013. NCQA provides updates bi-annually.
  13. 13. Thank you for participating in today’s webinar. Please don’t hesitate to contact us with any additional questions or for information about . www.Qfhc.com CJChitty@Qfhc.com
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