NCQA Recognition Notes

June 24, 2015 In The Press0

NCQA Has Helped Us Gain Leverage

National Committee on Quality Assurance

Palmetto Primary Care Physicians (PPCP) has earned NCQA Recognition in three programs: Diabetes Recognition Program (DRP), Heart/Stroke Recognition Program (HSRP), and Patient Centered Medical Home (PCMH). The practice is a Level III PCMH, and has area 30 practices throughout the greater Charleston, South Carolina area.

NCQA spoke with Jennifer O’Donnell, Director of Quality Operations, about how NCQA Recognition has changed the way PPCP delivers care.

NCQA: What interested you in becoming NCQARecognized?

O’Donnell: PPCP wanted national visibility as a quality leader. NCQA Recognition has helped us gain leverage in contracting with payers in South Carolina through various incentive programs and contracts. Our DRP, HSRP and PCMH-recognized physicians also get automatic credit for their Maintenance of Certification (Module IV) through the American Board of Family Medicine.

NCQA: How has becoming NCQA-Recognized changed the way you deliver care?

O’Donnell: NCQA Recognition helped us transform how our practice operates. DRP and HSRP Recognition set the framework for evidence-based care by setting benchmarks for providers and helping them prepare for HEDIS recommendations via our electronic medical record. DRP and HSRP have helped us increase market share and get payer contracts around quality outcomes. As we move forward in a health care delivery system that rewards value over volume, this becomes critical to our ongoing success.

NCQA: What surprised you about NCQA Recognition?

O’Donnell: NCQA Recognition forces us to work together as a team to complete the applications, particularly for the PCMH application, which is more intense than the other recognition programs.

NCQA: What’s the hardest part of undergoing three recognition evaluations?

O’Donnell: The pure volume of what we are trying to do, since we want to get many of our providers recognized. Forty-two of our providers are recognized in DRP and HSRP. We have submitted 22 Multi-Site PCMH applications and had 72 providers recognized for PCMH. We expect to add more by the end of the year. Gathering the data from so many people and departments, and making sure they meet standards, takes time.

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