Practices that want to use autocredit for the PCMH 2011 Survey:
Step 1: Obtain the NCQA-issued
Prevalidation Summary Approval Table and NCQA Letter of Product Autocredit Approval from the vendor, in addition to a letter of vendor products implemented and the date of implementation.
Step 2: Implement prevalidated products
for a minimum of 3 months before submitting the Survey Tool.
Step 3: Complete an application and enter
into required agreements for the NCQA Recognition program.
Step 4: Upload the vendor Prevalidation Summary Approval Table,
implementation letter and a copy of the NCQA Letter of Product Autocredit Approval into the Survey Tool’s document library.
Step 5: Upload specified documentation
into the document library, and for each factor awarded autocredit, enter the Attestation Statement into the factor’s “notes” field.
Step 6: Submit the Survey Tool.
Note: Find attestation language in the Letter of Product Autocredit Approval provided by the vendor.
Vendors that want to submit products for NCQA PCMH 2011 prevalidation:
Step 1: Purchase the PCMH 2011 Survey
Tool and attend NCQA’s Free ISS Trainings and/or an onsite Facilitating PCMH training session.
Step 2: Identify factors whose functionality
requirement is met by the product, using Documentation Guidelines Data Sources as a guide.*
Step 4: Submit the executed PCMH 2011 Prevalidation Program Agreement, Program Application and Application Checklist; submit the application fee per the Program Fee Schedule.
Step 5: Pre-submission demo call with
NCQA.
Step 6: Complete the PCMH Survey Tool;
alert NCQA of the intended submission date; send the final payment.
Step 7: NCQA reviews the survey and
reports the scoring decision in 45–60 days.
Step 8: Receive:
Prevalidation Summary Approval Table.
Letter of Product Autocredit Approval.
Marketing & Advertising Guidelines.
Step 9: Send proposed press release
language and other marketing materials to NCQA for approval.
* If a product’s functionality does not fully meet the factor’s requirement, NCQA will list all factors submitted, but not approved for autocredit on the Prevalidation Summary Approval Table.
NCQA would like to congratulate Phytel, Inc. on developing the Phytel Outreach, Insight and Coordinate solutions which have been awarded a total of 12.75 points in PCMH 2011 Autocredit. As of 4/30/2012, Phytel Inc. client practices utilizing Phytel Outreach, Coordinate and Insight may benefit from reduced documentation and have scoring associated with awarded Autocredit applied to their total PCMH 2011 Survey score. This is contingent upon the eligible practice or practice group and athenahealth, inc. meeting the requirements outlined in the attached PCMH 2011 Prevalidation Step-by-Step Guide for Client Practices and Participating Vendors. The documents accompanying this letter include: NCQA’s PCMH 2011 Prevalidation Summary Approval Table; Program Marketing & Advertising Guidelines; PCMH 2011 Prevalidation Program Step-by-Step Guide. It is essential that you read all documents thoroughly.
Phytel Inc. will be listed on NCQA’s PCMH Prevalidation Program webpage. Visitors to the site will be directed to [email protected] to receive additional product related information.
Below is a summary of the Autocredit awarded by product name(s) and the associated attestation language required for eligible practices to enter into their PCMH ISS Tool in order for awarded Autocredit to be applied to the total score of the practice’s PCMH 2011 Survey.
Product Name Total Autocredit
Awarded Factors Approved for
Autocredit Attestation Statement
Phytel Outreach
v.6.1.3 3.75 Points
PCMH2:D:1-3
Practice attests to the implementation and use of Phytel Outreach v.6.1.3 for associated Autocredit points as specified in the attached NCQA Prevalidation Summary Approval Table.
Mina Harkins Mina L. Harkins, BSMT(ASCP), MBA NCQA AVP, Recognition Programs
Product Name Total Autocredit
Awarded Factors Approved
for Autocredit Attestation Statement
Phytel Insight v.1.4
7.5 Points PCMH1:D:2 PCMH3:A:1-3 PCMH6:A:1-2
Practice attests to the implementation and use of Phytel Insight v.1.4 for associated autocredit points as specified in the attached NCQA Prevalidation Summary Approval Table.
Product Name Total Autocredit
Awarded Factors Approved
for Autocredit Attestation Statement
Phytel Coordinate
v.0.9.2 5.5 Points
PCMH3:A:1-3 PCMH4:A:1
Practice attests to the implementation and use of Phytel Coordinate v.0.9.2for associated autocredit points as specified in the attached NCQA Prevalidation Summary Approval Table.
How Phytel Supports Compliance with NCQA PCMH 2011 and ACO Standards March 2013
The Phytel platform is designed to help build a high performance Patient-Centered Medical Home based on population health management principles and best practices. A number of functions directly support specific elements of the PCMH 2011 standards set forth by NCQA and have been pre-validated for autocredit in the NCQA application process. Many other Phytel-enabled functions, when executed by the care team in the process of care delivery, enable demonstrated compliance with additional elements required to meet standards related to the management and coordination of care, fostering self-management capabilities, and demonstrating ongoing quality improvement.
Phytel’s implementation process prepares clients planning to apply for NCQA PCMH recognition by recommending relevant Outreach protocols and Insight measures, focusing on provider attribution and data integrity, and providing sample care management and quality improvement workflows that tie to specific standards and elements.
The following table lists specific NCQA PCMH standards and elements that are supported by functions within the Phytel platform. Factors in red are approved for autocredit; factors in blue are approved as support for the practice’s documented processes and activities for the related elements. In addition, where related NCQA’s ACO 2012 to PCMH 2011 Crosswalk has indicated commonality between the standards, this is noted.
Standard 1: Enhance Access and Continuity
1D: Continuity (multi-site) (ACO PC 1 K)
The practice provides continuity of care for patients/families by: Factor 2: Documenting the patient’s/family’s choice of clinician
1G: The Practice Team
(multi-site)
(ACO PC 1 C)
The practice provides a range of patient care services by:
Factor 2: Having regular team meetings or a structured communication process (“critical factor”)
Factor 6: Training and assigning care teams for patient population management
Standard 2: Identify and Manage Populations
2D: Use Data for Population Management
MUST PASS
(multi-site)
The practice uses patient information, clinical data and evidence-based guidelines to generate lists of patients and to proactively remind patients/families and clinicians of services needed for:
Factor 1: At least three different preventive care services
Factor 2: At least three different chronic or acute care services
Factor 3: Patients not recently seen by the practice
Standard 3: Plan and Manage Care
3A: Implement Evidence-Based Guidelines
(ACO PO 2 A and PC 1 D)
The practice implements evidence-based guidelines through point of care reminders for patients with:
Factor 1: The first important condition
Factor 2: The second important condition
Factor 3: The third condition, related to unhealthy behaviors or mental health or substance abuse
To identify high-risk or complex patients the practice:
Factor 1: Establishes criteria and a systematic process to identify high-risk or complex patients
3C: Care Management
MUST PASS
(ACO PC 1 E)
The care team performs the following for at least 75 percent of the patients identified in Elements A and B:
Factor 1: Conducts pre-visit preparations
Factor 6: Identifies patients/families who might benefit from additional care management support
Factor 7: Follows up with patients/families who have not kept important appointments
Standard 4: Provide Self-Care Support and Access to Community Resources
4A: Support Self-Care Process
MUST PASS
(ACO PC 1 G and CM 4 C)
The practice conducts activities to support patients/families in self-management:
Factor 1: Provides educational resources or refers at least 50 percent of patients/families to educational resources to assist in self-management
4B: Provide Referrals to Community Resources
(ACO PC 1 G and CM 4 C)
The practice supports patients/families that need access to community resources:
Factor 4: Offers opportunities for health education programs (such as group classes and peer support.)
Standard 5: Track and Coordinate Care
5C: Coordinate With Facilities and Care Transitions
On its own or in conjunction with an external organization, the practice systematically:
Factor 4: Demonstrates its process for contacting patients/families for appropriate follow-up care within an appropriate period following a hospital admission or emergency department visit
Standard 6: Measure and Improve Performance
6A: Measure Performance
The practice measures or receives data on the following:
Factor 1: At least three preventive care measures
Factor 2: At least three chronic or acute care clinical measures
Factor 4: Performance data stratified for vulnerable populations (to assess disparities in care).
6C: Implement Continuous Quality Improvement
MUST PASS
(ACO PC 1 J)
The practice uses an ongoing quality improvement process to:
Factor 1: Set goals and act to improve on at least three measures from Element A
Factor 3: Set goals and address at least one identified disparity in care/ service for vulnerable populations
6D: Demonstrate Continuous Quality Improvement
The practice demonstrates ongoing monitoring of the effectiveness of its improvement process by:
Factor 1: Tracking results over time
6E: Report Performance
The practice shares performance data from Element A and Element B:
Factor 1: Within the practice, results by individual clinician
Factor 2: Within the practice, results across the practice
Factor 3: Outside the practice to patients or publicly, results across the practice or by clinician.
