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HRSA Patient-Centered Medical/Health Home Initiative

Program Assistance Letter 2011-01

I. Purpose

This Program Assistance Letter (PAL) describes the Health Resources and Services Administration’s (HRSA) Patient-Centered Medical/Health Home (PCMHH) Initiative, which supports and encourages health centers to gain recognition under the medical home program offered in partnership with the National Committee for Quality Assurance (NCQA). This PAL outlines the processes and requirements for applying for recognition and highlights the technical support available under the HRSA PCMHH Initiative.

II. Introduction

Entities eligible to receive recognition services under the PCMHH Initiative are organizations that receive funding under the Health Center Program authorized in section 330 of the Public Health Service Act (42 U.S.C. 254b), as amended, specifically:

• Community Health Center (CHC) Programs, funded under section 330(e);
• Migrant Health Center (MHC) Programs, funded under section 330(g);
• Health Care for the Homeless (HCH) Programs, funded under section 330(h);
• Public Housing Primary Care (PHCP) Programs, funded under section 330(i); and
• FQHC Look-Alikes.

HRSA encourages and supports health centers as they strive to continuously improve quality and tailor their care to the needs of the patients and communities that they serve. The PCMHH Initiative will allow health centers to demonstrate their leadership as providers of high-quality care.

The PCMHH Initiative encourages health centers to undertake and document the practice changes that will enable them to gain recognition from NCQA though their Patient-Centered Medical Home (PCMH) program. To promote quality improvement, the PCMHH Initiative provides access to survey-related education, training, and technical assistance resources that highlight the benefits of seeking recognition and common barriers to success. The fee for gaining NCQA PCMH recognition is waived for health centers that participate in HRSA’s PCMHH Initiative.

Recognition under the NCQA PCMH program is distinct from ambulatory care accreditation, which is available through HRSA’s Accreditation Initiative; see Program Assistance Letter 2009-12 for more information. Health centers are encouraged to seek both accreditation and NCQA PCMH recognition. 

III. Initial Survey and Resources for Pre-Survey Preparation

Health centers should anticipate spending at least nine to twelve months for the planning and preparation process for gaining initial recognition, including the self-assessment process that compares the health center’s internal processes and practices with the standards for recognition. It is helpful to designate a lead staff member who is responsible for preparing the materials needed to apply for recognition. It is expected that health centers submit their final survey to obtain PCMH recognition within 12 months of their NOI being sent forward to NCQA.

Organizations interested in HRSA support for initial NCQA PCMH recognition under the PCMHH Initiative must complete a Notice of Intent (NOI) located at http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pal201101noi.pdf. The completed NOI must be submitted via email to PCMHHinitiative@hrsa.gov.

After HRSA approves the health center’s participation in the PCMHH Initiative, NCQA will send additional resources on the recognition process, including but not limited to:

• The PCMH program standards and guidelines;
• Information on telephone and email assistance available to health centers seeking PCMH recognition;
• Instructions on how to prepare for the PCMH recognition process and comply with the standards; and
• Details regarding the application process.

IV. Additional Services for NCQA PCMH-Recognized Health Centers under the PCMHH Initiative

1. Health Center Renewal Surveys
   
   NCQA PCMH recognition is granted for a period of three years, and health centers can maintain their recognition status through the renewal survey process. Grantees eligible for renewal surveys under the PCMHH Initiative will be contacted by NCQA to coordinate the process including the submission of a required NOI.
   
2. Increasing Recognition Level Through the Add-On Process

There are three levels of NCQA PCMH recognition. An already-recognized health center that seeks to increase its level of recognition is eligible to do so under the PCMHH Initiative. Health centers seeking add-on surveys must submit a NOI to HRSA.

V. Training and Educational Resources

NCQA has developed a series of technical assistance and training resources that highlight successful strategies for obtaining and maintaining PCMH recognition status. The training and educational resources that are available to all health centers under the PCMHH Initiative, include among others:

• Educational and training sessions;
• Webinar(s) on NCQA PCMH recognition standards;
• Recognition readiness self-assessment materials.

VI. Contacts 

Additional information regarding the NCQA PCMH recognition process can be found at http://www.ncqa.org/ or by contacting the NCQA project liaison at PCMH-GRIP@ncqa.org or 888-275-7585.

For additional information and resources on the PCMHH Initiative, please visit the website or contact the PCMHH Initiative Program Manager at PCMHHinitiative@hrsa.gov or 301-594-0818.