The focus on and interest in patient-centered care has been growing steadily in recent years, and several PCMH (Patient-Centered Medical Home) recognition programs have formed as a result. The National Committee for Quality Assurance’s (NCQA) program has become the “front runner,” according to a recent article in Physicians Practice (subscription may be required). To receive PCMH recognition through the NCQA, the article states, a practice must meet specific care elements in six standard categories. In 2013, however, it was discovered that there were reporting discrepancies between referring physicians and specialists when trying to meet these criteria. As a result, the NCQA went a step further and introduced the Patient-Centered Specialty Practice (PCSP) recognition program, a more stringent program that requires the PCSP-certified facility to “develop and maintain referral agreements and care plans with primary-care practices.” Specialists are also expected to “provide patient-centered care that includes the patient and possibly the family member or caregiver, when appropriate.”
As stated in the article, it is expected that these programs “will be further expanded over time and will gain recognition among payers. Because improved patient outcomes result in future cost savings, additional financial incentives are likely to emerge for the physicians that contribute to this effort. Such programs will continue to make a contribution to improving patient satisfaction and clinical outcomes.”
If these outcomes are achieved, it could also contribute to lower loss experience and lower insurance premiums over time. We’ll be watching to see if this occurs.