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Quality Assessment Group Rolls Out New Guidelines for Medical Homes

By Rebecca Adams, CQ HealthBeat Associate Editor

January 28, 2011 -- A leading health care quality assessment organization, the National Committee for Quality Assurance (NCQA), will release updated standards to give health providers who operate medical home programs a guide to earning accreditation.

Certification by NCQA can serve to validate the providers to payers and to patients who are trying to figure out which medical services to use. The NCQA model is the nation's most widely-used medical home program. Its preferred medical home practices often have a significant influence on the behavior of providers, such as physician practices or clinics. The goal behind medical homes is to offer a coordinated strategy for managing patients and providing responsive care that reflects the preferences of each patient.

In its new standards, NCQA encourages providers to adopt the new health information technology guidelines being pushed by the Department of Health and Human Services this year. The NCQA evaluation standards adopted HHS criteria and language, often word-for-word. NCQA officials will encourage providers to take such steps as electronic prescribing; maintaining a current list of diagnoses and medications; checking on drug interactions and allergies; recording patients' demographics; charting vital signs; recording smoking status; reporting on outpatient care quality measures; and implementing clinical decision support rules.

Some of the practices by medical providers that also will win points from NCQA evaluators include: after-hours care provided to patients; information in patients' preferred language; tailored explanations for pediatric patients; and evaluations from patients of their experience.

The quality assessment organization also is collaborating with the Agency for Healthcare Research and Quality to develop a survey evaluating patients' experiences in medical homes. The survey will be based on the NCQA's widely-used Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey. NCQA expects to release the survey information for medical homes in the second half of 2011.

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