PCMH Redesign Announcement

On March 31, 2017 NCQA released the new 2017 PCMH Standards. This program will replace the 2014 PCMH Standards. The 2017 Standards include a fairly comprehensive program redesign including new NCQA submission software, new names and an annual check in to sustain recognition.


Major changes to expect:

  1. Replaces the old Standards, Elements and Factors with the new and updated Concepts, Competencies and Criteria.

  2. Allows more flexibility by giving practices the opportunity to utilize their strengths and goals while working with their schedule to receive recognition.  

  3. Gives practices to have more interaction with NCQA as they will be assigned a NCQA representative to help guide you through the administrative part of the the PCMH recognition process. This should help practices better understand the application, purchases and timing that NCQA requires before you submit your PCMH documentation.

  4. Aims for a more user-friendly approach to showing you meet the PCMH requirements. The reporting process has been simplified, and what's even more exciting…less paperwork!

  5. Includes Electronic Clinical Quality Measures (eCQMs) which means that practices will now have the option to submit their clinical quality measures electronically. The list of measures that can be chosen for this can be found here.

  6. Encourages continuous improvement by establishing an annual PCMH check in which is designed to help practices work on performance improvement throughout each year and consistently. This continuous improvement will help practices in keeping on top of improvement and better systems means better outcomes for patients and providers.

  7. Allows practices to easily align with health care changes. According to NCQA, “the program aligns with current public and private initiatives and can adapt to future changes.”


3 phases to the new recognition process:

  1. Commitment phase: the practice takes a self-assessment to know where they stand and if they’re ready to become PCMH recognized. Once a practice commits, they are assigned an NCQA representative who will help them with through NCQA’s administrative process. The NCQA representative conducts an online assessment with the practice to develop a schedule for improvement and a plan for evaluation.

  2. Transformation phase: the practice begins to build on its success. The practice can submit all their data and documentation into NCQA’s new PCMH submission system. This is a great improvement because it can significantly reduce administrative hassles and cuts down on a lot of paperwork. During the transformation phase, the NCQA Reviewer conducts virtual check ins and document reviews designed to help practices evaluate their progress and determine next steps. This is another exciting addition because it allows the evaluation process to be more educational and collaborative.

  3. Success phase: the practice achieves NCQA PCMH recognition. What’s next? The practice continues to improve its PCMH model to better meet the needs of its patients. The practice will sustain their PCMH processes and be prepared for the annual check in with NCQA.


This dramatic program redesign is based on years of feedback and intends to streamline the NCQA PCMH recognition process, reduce the administrative burden on practices, and make the program increasingly relevant to practices of all sizes.

For any more information on this dramatic redesign check out NCQA’s website or click here.

By: Bethany Downs