Nurse-Led Medical Homes: Current Status and Future Plans

Laurie Scudder, DNP, NP

Disclosures

May 27, 2011

In This Article

Physician Practice Connection™--PCMH

NCQA, in conjunction with physician groups, has developed a recognition process called the Physician Practice Connection--Patient-Center Medical Home (PPC-PCMH) that ensures that practices earning this designation are able to deliver services consistent with the PCMH model of care.

A number of benefits resulting from PPC-PCMH recognition were discussed by Dr. Rothman including:

  • Improvements in healthcare: including higher quality, lower cost, and improved patient satisfaction;

  • Recognition: NCQA's program is the most widely used and brings credibility to the practices it recognizes;

  • Practicality: NCQAs plan allows for practice transformation and defines the best of primary care;

  • Evidence base: The plan is built on a solid research foundation;

  • Team base: The NCQA model is collaborative;

  • Flexibility: The NCQA plan is applicable to a wide range of practice models; and

  • Value: NCQA recognition addresses and solves a problem with a common solution for both states and practices and payers acknowledge the value.

The PPC-PCMH program ensures that practices earning this designation are able to deliver services consistent with the PCMH model of care. Practices may be awarded 1 of 3 levels (basic, intermediate, and advanced) with each level reflecting a different degree of PCMH service capability. Nurse-managed centers are evaluated by NCQA using these same quality measures and, in order to be awarded accreditation, must meet them as defined by the identical criteria. Within the PCMH standards are 6 must-pass elements that are considered essential and are required at all recognition levels. Practices must achieve a score of 50% or higher on these elements:

  • PCMH 1: Enhance Access and Continuity;

  • PCMH 2: Identify and Manage Patient Populations;

  • PCMH 3: Plan and Manage Care;

  • PCMH 4: Provide Self-Care and Community Support;

  • PCMH 5: Track and Coordinate Care; and

  • PCMH 6: Measure and Improve Performance.

NCQA's site provides a wealth of resources for NPs considering this important next step.

Best Practices: NCQA-Accredited Nurse-Led Medical Homes

The conference provided admirable examples of NP-run practices that have already earned this recognition with a focus on 3 NP-led practices in the Northeast. All earned NCQA recognition based on their achievement of standards detailed in the PPC-PCMH documents. NAQC, in conjunction with the Robert Wood Johnson Foundation, has developed informational brochures about each of these practices, which can be accessed by clicking on the links below.

Family Practice & Counseling Network (FPCN) in Philadelphia, Pennsylvania.

Life Long Care, PLLC in New London, New Hampshire.

PHMC Health Connection in Philadelphia, Pennsylvania.

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