Table 5.
Count and Percentage of Items in PCMH Tools, by 2014 NCQA PCMH Standard and Element (including PCMH scoring details)
| 2014 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 | |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Patient-Centered Access | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% |
| A | Patient-centered appointment accessa | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% |
| B | 24/7 access to clinical advice | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% |
| C | Electronic access | 3 | 8% | 1 | 4% | 0 | N/A | 0 | N/A | 6% |
| 2 | Team-Based Care | 23 | 64% | 9 | 36% | 4 | 25% | 9 | 26% | 31% |
| A | Continuity | 6 | 17% | 2 | 8% | 1 | 6% | 1 | 3% | 7% |
| B | Medical home responsibilities | 1 | 3% | 1 | 4% | 0 | N/A | 0 | N/A | 3% |
| C | Culturally and Linguistically Appropriate Services | 3 | 8% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| D | The practice teama | 22 | 61% | 6 | 24% | 2 | 13% | 7 | 20% | 22% |
| 3 | Population Health Management | 9 | 25% | 6 | 24% | 4 | 25% | 12 | 34% | 25% |
| A | Patient information | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| B | Clinical data | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| C | Comprehensive health assessment | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| D | Use data for population managementa | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| E | Implement evidence-based decisionsupport | 5 | 14% | 5 | 20% | 3 | 19% | 10 | 29% | 19% |
| 4 | Care Management and Support | 13 | 36% | 13 | 52% | 6 | 38% | 19 | 54% | 45% |
| A | Identify patients for care management | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| B | Care planning and self-care supporta | 12 | 33% | 12 | 48% | 6 | 38% | 17 | 49% | 43% |
| C | Medication management | 5 | 14% | 1 | 4% | 1 | 6% | 2 | 6% | 6% |
| D | Use electronic prescribing | 1 | 3% | 1 | 4% | 0 | N/A | 2 | 6% | 4% |
| E | Support self-care and shared decisionmaking | 3 | 8% | 4 | 16% | 1 | 6% | 4 | 11% | 10% |
| 5 | Care Coordination and Care Transitions | 6 | 7% | 7 | 28% | 4 | 25% | 6 | 17% | 21% |
| A | Test tracking and follow-up | 1 | 3% | 1 | 4% | 0 | N/A | 1 | 3% | 3% |
| B | Referral tracking and follow-upa | 6 | 17% | 6 | 24% | 4 | 25% | 5 | 14% | 20% |
| C | Coordinate care transitions | 6 | 17% | 6 | 24% | 4 | 25% | 5 | 14% | 20% |
| 6 | Performance Measurement and Quality Improvement | 12 | 33% | 5 | 20% | 2 | 13% | 2 | 6% | 16% |
| A | Measure clinical quality performance | 4 | 11% | 0 | N/A | 0 | N/A | 0 | N/A | 11% |
| B | Measure resource use and care coordination | 4 | 11% | 0 | N/A | 0 | N/A | 0 | N/A | 11% |
| C | Measure patient/family experience | 6 | 17% | 3 | 12% | 1 | 6% | 0 | N/A | 12% |
| D | Implement continuous QIa | 10 | 28% | 2 | 8% | 1 | 6% | 0 | N/A | 8% |
| E | Demonstrate continuous QI | 7 | 19% | 0 | N/A | 0 | N/A | 0 | N/A | 19% |
| F | Report performance | 1 | 3% | 0 | N/A | 0 | N/A | 0 | N/A | 3% |
| G | Use certified EHR technology | 1 | 3% | 1 | 4% | 0 | N/A | 2 | 6% | 4% |
EHR indicates electronic health record; MHCCS-H, 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.