PCMH Incentive Programs
Patient-centered medical home (PCMH) incentive programs are local, state, and public/private payer initiatives that offer payment incentives to participating practices that adopt the functions of a PCMH. Examples of initiatives that are operating in Louisiana include the following programs:
- Quality Blue Primary Care Program: Quality Blue Primary Care (QBPC) is Blue Cross and Blue Shield of Louisiana's innovative population health and quality improvement program. QBPC is designed to get better outcomes for patients with chronic diseases, support doctors and transform healthcare delivery. Learn More
- Bayou Health Medicaid Coordinated Care Networks
- Cigna Accountable Care Program - The Baton Rouge Clinic ACO: Cigna and the Baton Rouge Clinic have launched a collaborative accountable care initiative to improve patient access to health care, enhance care coordination and achieve the “triple aim” of improved health, affordability and patient experience. Learn More
Note: Many PCMH incentive programs require participation in a designated PCMH recognition or accreditation program (see below).
PCMH Recognition and Accreditation Programs
A number of national PCMH recognition and accreditation programs are available. Some practices are required to complete a PCMH recognition program (e.g., for participation in an accountable care organization [ACO] or PCMH incentive program), but PCMH recognition for many practices is voluntary.
To determine whether your practice is required to participate in a recognition or accreditation program, refer to your ACO, PCMH incentive program, federal grant (e.g., Health Resources and Services Administration), and major practice payer (e.g., Medicaid, private insurance, etc.) agreements. If recognition is required, your agreement will typically designate a specific recognition program for you to complete.
If you are not required to participate in a recognition program but choose to do so anyway, research the available programs to determine which is most appropriate for your practice. Be sure to consider the application cost, data and documentation requirements, and staff resources required to complete the application process. Use this information to formulate a complete picture of the total costs—monetary and resource-wise—associated with each program.
National Recognition and Accreditation Programs
Accreditation Association for Ambulatory Health Care (AAAHC) Medical Home On-site Certification (www.aaahc.org)
National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH 2014) Recognition (www.ncqa.org)
The Joint Commission (TJC) Designation for Your Primary Care Home (www.jointcommission.org)
URAC Patient-Centered Medical Home Accreditation (www.urac.org)