NCQA to release new standards following critical medical home study

Following a scathing study showing that patient-centered medical homes did not lower costs, the leading accreditation agency for medical homes faces criticism that its approvals rely too much on processes and not enough on outcomes.

On March 10, the National Committee for Quality Assurance, which recognizes more than 6,800 physician practices as medical homes, will unveil revised standards to show its recognition process holds value. NCQA accreditation suggests the practices are prepared to offer patients coordinated, higher-quality, lower-cost care.

The new standards, to be launched March 24, will shift their focus to align with HHS meaningful-use requirements for information technology, enhance team-based care, target high-need populations and advance the triple-aim goals of increasing quality, lowering cost and improving patient experience.

In a study published in the Journal of the American Medical Association, RAND researchers compared 32 NCQA-recognized practices in southeast Pennsylvania with 29 that were not. Over three years, a significant difference was found in only one of 11 quality measures and there was “no robust association with utilization or costs.”

“The big lesson is that we have kind of allowed the patient-centered medical home brand to be equated with NCQA recognition,” said Dr. Bruce Bagley, CEO of TransforMED, a medical home consulting group. “We do ourselves a collective disservice by allowing that to happen.” NCQA standards serve as a good starting guide for practices organizing medical homes. But practices need to focus on outcomes, Bagley said.

Others were harsher. The NCQA medical home survey “should never be used by itself to assess a true patient-centered medical home,” Francois de Brantes, executive director of the Health Care Incentives Improvement Institute, wrote in a blog post.

Follow Andis Robeznieks on Twitter: @MHARobeznieks