NCQA launching patient-centered specialty-practice recognition program

The National Committee for Quality Assurance is gearing up for a March 25 launch of a patient-centered specialty-practice recognition program modeled after its successful patient-centered medical home program.

The new program will recognize specialty practices that meet standards for care coordination and management, Margaret O'Kane, NCQA's president, said during a sneak preview webinar Thursday.

An average Medicare beneficiary sees seven physicians and fills 20 prescriptions each year, O'Kane said, citing a statistic she says illustrates the need for improved communication across care sites.

The specialty-practice recognition program will consist of six standards, including tracking and coordinating of referrals, providing access and communicating with patients, planning and managing care, and measuring and improving performance.

Although the program is designed to build on the organization's existing medical-home model—which has more than 26,000 participating clinicians at nearly 5,500 sites—there are key differences between the two programs, NCQA said. For instance, one standard—identifying and coordinating patient populations—is applied more broadly in medical-home recognition but has a more narrow range, relevant to the specialty area, in the new program.

The prime targets of the program are oncology, endocrinology, cardiology and other specialties that tend to take on care-management roles for patients, said Tricia Barrett, NCQA's vice president of product development. But any specialty practice, even those that provide more episodic care, can benefit from the recognition, added Dr. John Cox, a physician with Dallas-based Texas Oncology.

“All practices have a need to share information,” said Cox, who helped design the program's standards.

Fifty-seven early adopters have signed on to implement the program, O'Kane said. She also predicted that purchasers and health plans would use the specialty practice recognition program to drive referrals to preferred sites of care and make care coordination payments available to specialists.