PCMH Recognition Criteria

The table below details the requirements for recognition as a medical home in the Maryland PCMH program. The Maryland requirements are a combination of overall NCQA PCMH recognition level and compliance with "must pass" elements in the NCQA standards. Use the cells in the "Requirements Met?" column to indicate your NCQA compliance level and determine your Maryland recognition status (displayed at the bottom of the column.)

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Requirements (all included in NCQA PCMH Review)  Maryland Recognition Level Specific NCQA Requirement Requirement Met?
Level 1 + Level 2 + Level 3 +
Level 1 NCQA PCMH Recognition ü     1. Overall NCQA Recognition Level  
Level 2 NCQA PCMH Recognition   ü  
Level 3 NCQA PCMH Recognition     ü
24-7 phone response with clinician for urgent needs  ü ü ü 2. Response of Yes to PPC 1A Factor #8  
Registry as part of EHR or as stand-alone  ü ü ü 3. Score of 50% for PPC 2F  
Summary of care record for transitions  ü ü ü 4. Response of Yes to PPC 3E Factor #9  
Advanced access for appointments  ü ü ü 5. Response of Yes to PPC 1B Factor #2  
Care management and coordination by specially trained team members  ü ü ü 6. Response of Yes to PPC 3C Factor #4  
Problem list for all patients  ü ü ü 7. Response of Yes to PPC 2D Factor #1  
Medication reconciliation every visit  ü ü ü 8. Response of Yes to PPC 2D Factor #3  
Pre-visit planning and after-visit follow-up for care management  ü ü ü 9. Response of Yes to PPC 2F Factor #1  
10. Response of Yes to PPC 3C Factor #1  
11. Response to Yes to PPC 3D Factors #1 and #11  
EHR with decision support    ü ü 12. Score of 100% for PPC 3B  
CPOE for all orders; test tracking and follow-up    ü ü 13. Score of 100% for PPC 6A  
E-prescribing    ü ü 14. Score of 75% for PPC 5A  
Self-management support    ü ü 15. Score of 50% for PPC 4B  
Decision support: drug-drug, drug-allergy and drug-formulary      ü 16. Score of 50% for PPC 5B  
17. Score of 50% for PPC 5C  
Reporting of relevant clinical measures      ü 18. Score of 100% for PPC 8A  
    None

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