Table 4.
Count and Percentage of Items in PCMH Tools, by 2011 NCQA PCMH Standard and Element (including PCMH scoring details)
| 2011 NCQA PCMH Standard & Element | PCMH-A (n) | PCMH-A (%) | MHI-LV (n) | MHI-LV (%) | MHI-SV (n) | MHI-SV (%) | MHCCS-H (n) | MHCCS-H (%) | MEDIAN | |
|---|---|---|---|---|---|---|---|---|---|---|
| Enhance Access and Continuity | 27 | 75% | 12 | 48% | 4 | 25% | 9 | 26% | 37% | |
| Access during office hoursa | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% | |
| Access after hours | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% | |
| Electronic access | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% | |
| Continuity | 6 | 17% | 2 | 8% | 1 | 6% | 1 | 3% | 7% | |
| Medical home responsibilities | 1 | 3% | 1 | 4% | 0 | N/A | 0 | N/A | 3% | |
| Culturally and Linguistically Appropriate Services | 3 | 8% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Practice organization | 22 | 62% | 8 | 32% | 2 | 13% | 7 | 20% | 26% | |
| Identify and Manage Patient Populations | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Patient information | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Clinical data | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Comprehensive health assessment | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Using data for population managementa | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Plan and Manage Care | 11 | 31% | 13 | 52% | 5 | 31% | 19 | 54% | 42% | |
| Implement evidence-based guidelines | 5 | 14 % | 5 | 20% | 3 | 19% | 10 | 29% | 19% | |
| Identify high-risk patients | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Manage carea | 10 | 28% | 11 | 44% | 5 | 31% | 17 | 49% | 38% | |
| Manage medications | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% | |
| Electronic prescribing | 1 | 3% | 2 | 8% | 0 | n/a | 2 | 6% | 6% | |
| Provide Self-Care and Community Support | 10 | 28% | 14 | 56% | 6 | 38% | 18 | 51% | 45% | |
| Self-care processa | 5 | 14% | 5 | 20% | 2 | 13% | 8 | 23% | 17% | |
| Referrals to community resources | 6 | 17% | 13 | 52% | 5 | 31% | 11 | 31% | 31% | |
| Track and Coordinate Care | 7 | 19% | 8 | 32% | 4 | 25% | 6 | 17% | 22% | |
| Test tracking and follow-up | 1 | 3% | 1 | 4% | 0 | N/A | 1 | 3% | 3% | |
| Referral tracking and follow-upa | 6 | 17% | 7 | 28% | 4 | 25% | 5 | 14% | 21% | |
| Coordinate with facilities/care transitions | 6 | 17% | 7 | 28% | 4 | 25% | 5 | 14% | 21% | |
| Measure and improve performance | 12 | 33% | 4 | 16% | 2 | 13% | 0 | 0% | 14% | |
| Measures of performance | 4 | 11% | 0 | N/A | 0 | N/A | 0 | N/A | 11% | |
| Patient/family feedback | 6 | 17% | 3 | 12% | 1 | 6% | 0 | N/A | 12% | |
| Implements continuous QIa | 10 | 28% | 2 | 8% | 1 | 6% | 0 | N/A | 8% | |
| Demonstrates continuous QI | 7 | 19% | 0 | N/A | 0 | N/A | 0 | N/A | 19% | |
| Performance reporting | 1 | 3% | 0 | N/A | 0 | N/A | 0 | N/A | 3% | |
| Report data externally | 1 | 3% | 0 | N/A | 0 | N/A | 0 | N/A | 3% | |
MHCCS-H indicates Medical Home Care Coordination Survey–Healthcare Team; MHI-LV, Medical Home Index–Long Version; MHI-SV, Medical Home Index–Short Version; N/A, not applicable; NCQA, National Committee for Quality Assurance; PCMH, patient-centered medical home; PCMH-A, Patient-Centered Medical Home Assessment Tool; QI, quality improvement.
a
Must-pass elements.