NCQA to re­lease new stan­dards fol­low­ing crit­i­cal med­i­cal home study

Modern Healthcare - - THE WEEKEND AHEAD - —An­dis Robeznieks

Fol­low­ing a scathing study show­ing that pa­tient-cen­tered med­i­cal homes did not lower costs,

the leading ac­cred­i­ta­tion agency for med­i­cal homes faces crit­i­cism that its ap­provals rely too much on pro­cesses and not enough on out­comes.

On March 10, the Na­tional Com­mit­tee for Qual­ity As­sur­ance, which rec­og­nizes more than 6,800 physi­cian prac­tices as med­i­cal homes, will un­veil re­vised stan­dards to show its recog­ni­tion process holds value. NCQA ac­cred­i­ta­tion sug­gests the prac­tices are pre­pared to of­fer pa­tients co­or­di­nated, higher-qual­ity, lower-cost care.

The new stan­dards, to be launched March 24, will shift their fo­cus to align with HHS mean­ing­ful-use re­quire­ments for in­for­ma­tion tech­nol­ogy, en­hance team-based care, tar­get high-need pop­u­la­tions and ad­vance the triple-aim goals of in­creas­ing qual­ity, low­er­ing cost and im­prov­ing pa­tient ex­pe­ri­ence.

In a study pub­lished in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion, RAND re­searchers com­pared 32 NCQA-rec­og­nized prac­tices in south­east Penn­syl­va­nia with 29 that were not. Over three years, a sig­nif­i­cant dif­fer­ence was found in only one of 11 qual­ity mea­sures and there was “no ro­bust as­so­ci­a­tion with uti­liza­tion or costs.”

“The big les­son is that we have kind of al­lowed the pa­tient-cen­tered med­i­cal home brand to be equated with NCQA recog­ni­tion,” said Dr. Bruce Ba­gley, CEO of Trans­forMED, a med­i­cal home con­sult­ing group. “We do our­selves a col­lec­tive dis­ser­vice by al­low­ing that to hap­pen.” NCQA stan­dards serve as a good start­ing guide for prac­tices or­ga­niz­ing med­i­cal homes. But prac­tices need to fo­cus on out­comes, Ba­gley said.

Oth­ers were harsher. The NCQA med­i­cal home sur­vey “should never be used by it­self to as­sess a true pa­tient-cen­tered med­i­cal home,” Fran­cois de Brantes, ex­ec­u­tive di­rec­tor of the Health Care In­cen­tives Im­prove­ment In­sti­tute, wrote in a blog post.


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