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Last Updated: May 2019
Resource Directory of Incentives for NCQA Recognition The Resource Directory of Incentives for NCQA Recognition links clinicians to local financial and non-financial resources that support Recognition. The directory includes a list of public, private and multi-payer initiatives, by state, that support a variety of NCQA Recognition programs including: Patient Centered Medical Home (PCMH), Patient Centered Specialty Practice (PCSP), Patient Centered Connected CareTM, Diabetes Recognition Program (DRP), and Heart and Stroke Recognition Program (HSRP). NCQA PCMH Recognition. NCQA PCMH Recognition is the most widely-used way to transform primary care practices into medical homes. More than 13,000 practices (with more than 60,000 clinicians) are recognized – close to 20 percent of all primary care physicians.
How PCMH benefits clinicians and practices: • Earn higher reimbursement. More than 50 payers nationwide offer enhanced reimbursement for recognized clinicians or support for
practices to become recognized. • Succeed in MACRA. Clinicians in NCQA-Recognized PCMHs/PCSPs automatically earn full credit in the MIPS Improvement Activities
category and are likely to do well in other MIPS categories. • Earn Maintenance of Certification (MOC) credits. Several medical boards award clinicians in NCQA-recognized practices Maintenance
of Certification (MOC) credits, reducing the burden on clinicians to take on additional activities. • Focus on patient care. The PCMH model ensures that team members operate at the highest level of their knowledge, skills, abilities and
license, within their assigned roles and responsibilities. Resources
• Toolkit: Getting Started with NCQA PCMH Recognition • Evidence Report • Training (On-site or On-demand)
Partners in Quality The directory also highlights organizations and initiatives that are designated NCQA Partners in Quality (PIQ). The PIQ program is available for organizations and initiatives that provide a specific set of resources and services that support practices in pursuit of practice transformation. Entities designated as NCQA Partners in Quality receive an application discount code to offer participating practices. Learn More To share updates or learn about the PIQ program, please contact Marsha Hertzberg ([email protected])
Directory of PCMH Resources and Incentive Programs
Page 2 of 61
Resources Key
Symbol Meaning
Financial Incentives or Assistance with Application Fees Organization or initiative offers financial incentives (e.g., increased PMPM). Note that incentives may not be offered to all network providers or all markets.
Learning Collaborative Support Organization or initiative offers in-kind support in the form of learning collaboratives (e.g., sharing of best practices) to support practices pursuing and sustaining NCQA recognition.
Care Management Support Organization or initiative offers in-kind support in the form of care management (e.g., additional staff resources) to support practices pursuing and sustaining NCQA recognition.
Onsite Coaching/Technical Assistance Organization or initiative offers in-kind support in the form of on-site coaching or technical assistance to support practices pursuing and sustaining NCQA recognition.
Medical Board Maintenance of Certification (MOC) Credit Certified physicians enrolled in specified NCQA recognition programs are eligible for Part IV Maintenance of Certification credit.
Partner in Quality This organization provides financial incentives or other support to practices seeking recognition and can provide supported practices with a PIQ discount code.
Supportive Technology Organization offers technology solutions (e.g., web-based software, data analytics) to support practices pursuing and sustaining NCQA recognition.
Directory of PCMH Resources and Incentive Programs
Page 3 of 61
Organization Type Use of NCQA Recognition
Resources Learn More
National Payers
Amerigroup Health Plan
PCMH
Refer to program website
Centene Health Plan
PCMH
Refer to program website
Humana Health Plan
PCMH
Refer to program website
United Health Group Health Plan
PCMH
Refer to program website
Medical Boards
American Board of Family Medicine
Medical Board
PCMH, DRP, HSRP
Refer to program website or Email [email protected]
American Board of Internal Medicine
Medical Board
PCMH; PCSP
Refer to organization website
American Board of Pediatrics Medial Board
PCMH
Refer to organization website or email [email protected]
American Board of Physical Medicine and Rehabilitation
Medical Board
PCSP
Refer to organization website
Directory of PCMH Resources and Incentive Programs
Page 4 of 61
Organization Type Use of NCQA Recognition
Resources Learn More
Supportive Technology
STEPS Forward™ Transformation Series
HIT Solution
PCMH
The STEPS Forward™ transformation series is a collection of interactive, educational modules designed to provide you with proven strategies that can improve practice efficiency and help you reach the Quadruple Aim. Steps Forward is brought to you by the American Medical Association. Visit www.stepsforward.org for more information.
AccentHealth HIT Solution
PCMH
Refer to organization website
ACP Practice Advisor HIT Solution
PCMH
Refer to organization website
Arcadia HIT Solution
PCMH
Refer to organization website
BizMed Solutions HIT Solution
PCMH
Refer to organization website or email [email protected]
PCMH Assure HIT Solution
PCMH
Refer to organization website
Directory of PCMH Resources and Incentive Programs
Page 5 of 61
PCMH 360 HIT Solution
PCMH
Refer to organization website
Directory of PCMH Resources and Incentive Programs
Page 6 of 61
Alabama Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
Blue Cross Blue Shield of Alabama
Health Plan
Recognizes NCQA PCMH and DRP
* Payment with higher recognition level
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 7 of 61
Alaska
Current NCQA Recognitions - Report Card and Interactive Map
Organization
Type Use of NCQA
Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 8 of 61
Arizona
Current NCQA Recognitions - Report Card and Interactive Map
Organization
Type Use of NCQA
Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 9 of 61
Arkansas
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Arkansas Blue Cross Blue Shield
Health Plan
Recognizes NCQA PCMH; DSP; HSRP
$ = Financial incentives
Refer to PCMH Frequently Asked Questions and Overview or 2019 PCMH Provider Manual
Arkansas Foundation for Medical Care
QIO Transformation support services to help practices achieve NCQA PCMH
Refer to program website or email: [email protected] or call 501-212-8733
Directory of PCMH Resources and Incentive Programs
Page 10 of 61
California
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition Resources Learn More CalPERS Public
Employees Retirement System
Recognizes NCQA PCMH
Contact CalPERS for contract language.
Covered California Marketplace Recognizes NCQA PCMH Contact Covered California for 2018 QHP Contract
LA Care Health Plan Health Plan Recognizes NCQA PCMH; (DRP; HSRP
Refer to program website
Central California Alliance for Health
Health Plan Recognizes NCQA PCMH and provides Transformation Support Services
Refer to program website
California Primary Care Association
Membership Org.
Transformation support services to help practices achieve NCQA PCMH
Refer to PCMH Transformation Tools website
Directory of PCMH Resources and Incentive Programs
Page 11 of 61
Colorado Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition Resources Learn More Colorado Accountable Care Collaborative's Primary Care Alternative Payment Model
Multipayer
Requires medical home recognition and recognizes NCQA.
Refer to program website
Rocky Mountain Health Plan
Health Plan Recognizes NCQA PCMH and PCSP
Refer to program website
Colorado Regional Health Information Organization
REC
Transformation support services to help practices achieve NCQA PCMH
Refer to program website
HealthTeamWorks Consultant Transformation support services to help practices achieve NCQA PCMH
Refer to program website or complete and submit inquiry form
Colorado Community Health Network
Membership Org.
Transformation support services to help practices achieve NCQA PCMH
Refer to organization website or contact [email protected]
Directory of PCMH Resources and Incentive Programs
Page 12 of 61
Connecticut Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Connecticut Advanced Medical Home Vanguard Program (SIM)
Multi-Payer Mandates NCQA PCMH
Refer to program website or Request for Applications (RFA) document
Connecticut Dept. of Social Services, HUSKY Health PCMH Program
Medicaid Mandates NCQA PCMH
Refer to program website or contact PCMH Administrator at [email protected].
Community Health Network of Connecticut
ASO
Mandates NCQA PCMH
Refer to program website
Qualidigm Consultancy; QIO
Transformation support services to help practices achieve NCQA PCMH and PCSP
Refer to program website or contact Michele Kelvey-Albert at [email protected]
Directory of PCMH Resources and Incentive Programs
Page 13 of 61
Delaware
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition Resources Learn More
Medical Society of Delaware
Membership Org.
Transformation support services to help practices achieve NCQA PCMH
Visit organization website
Directory of PCMH Resources and Incentive Programs
Page 14 of 61
District of Columbia Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
MyHealth GPS (Health Home 2 Program)
Medicaid Requires NCQA PCMH
Refer to program webpage.
Directory of PCMH Resources and Incentive Programs
Page 15 of 61
Florida
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA Recognition Resources Learn More
Medicaid MMA Physician Incentive Program
Medicaid Recognizes NCQA PCMH
Refer to program website.
Blue Cross Blue Shield of Florida
Health Plan Recognizes NCQA PCMH
Refer to program website. Note that this practice participation is invitation only.
Sunshine Health
Health Plan Recognizes NCQA PCMH
Refer to program website
Center for the Advancement of Health IT REC
REC Transformation support to help practices achieve PCMH or PCSP
Refer to progam website or email [email protected]
University of Central Florida REC
REC Transformation support to help practices achieve PCMH or PCSP
Refer to program website or email [email protected]
Florida Chapter- American Academy of Pediatrics
Membership Org.
Transformation support to help practices achieve PCMH
website
Florida Academy of Family Physicians
Membership Org.
Transformation support to help practices achieve PCMH
Refer to program website.
Directory of PCMH Resources and Incentive Programs
Page 16 of 61
Community Care Plan
Health Plan
Recognizes NCQA PCMH
Visit program website. or call 1-855-819-9506
Simply Healthcare Health Plan Recognizes NCQA PCMH
Refer to program website
Pediatric Innovation Center
QIO/CIN
Transformation support to help practices achieve PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 17 of 61
Georgia
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Wellcare of Georgia Health Plan Mandates NCQA PCMH
* Payment with higher recognition level
Refer to program website or email [email protected]
Peach State Health Plan
Health Plan Mandates NCQA PCMH
Refer to program website
Georgia Chapter American Academy of Pediatrics
Membership Org.
Transformation support services to help practices achieve NCQA PCMH
Refer to program website
Georgia Academy of Family Physicians
Membership Org.
Transformation support services to help practices achieve NCQA PCMH and PCSP
Refer to program website or email [email protected]
CareSource Georgia Co.
Health Plan Mandates NCQA PCMH
Visit program website Or Call Member Services: 1-855-202-0729
Patient-Centered Medical Home
Medicaid GA Office of Rural Health - Pilot
Directory of PCMH Resources and Incentive Programs
Page 18 of 61
Supplemental Funding Grant
Directory of PCMH Resources and Incentive Programs
Page 19 of 61
Hawaii
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Hawaii Medicaid Patient Centered Medical Home Program (via MCO contracts)
Medicaid Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to Hawaii MCO contract language (page 300)
Directory of PCMH Resources and Incentive Programs
Page 20 of 61
Idaho
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Idaho Healthy Connections Program
Medicaid Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to program website or contact the Healthy Connections Consolidated Unit at 1-888-528-5861
Directory of PCMH Resources and Incentive Programs
Page 21 of 61
Illinois
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Molina Healthcare Health Plan
Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to program website or contact [email protected]
Meridian Health Plan
Health Plan
Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to provider orientation handbook
Directory of PCMH Resources and Incentive Programs
Page 22 of 61
Indiana Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
eHealthcare Consulting
Consulting Transformation support to help practices achieve NCQA PCMH or PCSP
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 23 of 61
Iowa
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Iowa Chronic Care Health Home Program
Medicaid Recognizes NCQA PCMH
Refer to program website
Telligen REC Transformation support to help practices achieve NCQA PCMH
Refer to program website or complete and submit interest form
Directory of PCMH Resources and Incentive Programs
Page 24 of 61
Kansas
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
Blue Cross Blue Shield of Kansas (Quality Based Reimbursement Program)
Health Plan Recognizes NCQA PCMH
Refer to program website
Kansas Association for the Medically Underserved
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Visit program website
Directory of PCMH Resources and Incentive Programs
Page 25 of 61
Kentucky
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Greater Louisville Medical Society
Membership Org.
Transformation support to help practices achieve NCQA PCMH, PCSP
Refer to program website
Kentucky Regional Extension Center
REC Transformation support to help practices achieve NCQA PCMH
Visit program website or email [email protected]
Directory of PCMH Resources and Incentive Programs
Page 26 of 61
Louisiana
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Bayou Health Patient Centered Medical Home Program (via MCO contracts)
Medicaid Mandates NCQA PCMH
Refer Bayou Health MCO contract (page 94) or contact MCO’s directly
Louisiana Healthcare Quality Forum
QIO Transformation support to help practices achieve recognition.
Refer to organization website or contact [email protected]
Louisiana Healthcare Connections
Health Plan Recognizes NCQA PCMH and PCSP
* Payment with higher recognition level
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 27 of 61
Maine
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Maine Health Home Program Medicaid Mandates NCQA PCMH
Refer to program website or email [email protected]
Maine Health Management Coalition/Pathways to Excellence
Membership Org.
Publishes NCQA recognition status for PCMH, PCSP, DRP and HSRP on public reporting program for consumers
No direct financial incentives, but large employers use ratings to create tiered benefit designs where practices' reimbursement is impacted on ratings
Refer to program website or contact
Maine Primary Care Association
Membership Org.
Transformation support services to help practices achieve PCMH; DRP; HSRP
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 28 of 61
Maryland
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 29 of 61
Massachusetts
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
Massachusetts Health Policy Commission PCMH PRIME Program
Medicaid Mandates MA HPC PCMH PRIME, which requires NCQA PCMH *Program developed in partnership with NCQA, which requires NCQA PCMH + additional behavioral health criteria.
Refer to program website or access application. HPC can be reached directly at [email protected].
Massachusetts eHealth Collaborative Rec
REC Transformation support to help practices achieve NCQA PCMH
Refer to program webpage
Directory of PCMH Resources and Incentive Programs
Page 30 of 61
Michigan
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
Michigan SIM PCMH Program
Multi-Payer
Recognizes NCQA PCMH
Refer to SIM PCMH Compliance Guide or contact the SIM Team at [email protected]
Meridian Health Plan
Health Plan
Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to program flyer
Priority Health Health Plan
Recognizes NCQA PCMH
Contact your provider account representative
Medical Advantage Group
Consultant Transformation support to help practices achieve NCQA PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 31 of 61
Minnesota
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 32 of 61
Mississippi
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 33 of 61
Missouri
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
MO Health Net Primary Care Health Home Program
Medicaid Mandates NCQA PCMH
Refer to program webpage or contact Marcia Seabourne, HH Enrollment Coordinator at [email protected]
Directory of PCMH Resources and Incentive Programs
Page 34 of 61
Montana
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
Blue Cross Blue Shield of Montana
Health Plan
Recognizes NCQA PCMH
Visit organization website.
Directory of PCMH Resources and Incentive Programs
Page 35 of 61
Nebraska
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
Wellcare of Nebraska
Health Plan
Recognizes PCMH
Visit organization website for more information or contact [email protected]
Directory of PCMH Resources and Incentive Programs
Page 36 of 61
Nevada
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 37 of 61
New Hampshire Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 38 of 61
New Jersey
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
New Jersey Academy of Family Physicians
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Refer to program website or email [email protected]
New Jersey HITECH REC
REC Transformation support to help practices achieve NCQA PCMH
Refer to program website
New Jersey Chapter, American Academy of Pediatrics
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 39 of 61
New Mexico Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
Centennial Care (via MCO Contracts)
Medicaid Recognizes NCQA PCMH
*MCO’s may provide Payment with higher recognition level
See Centennial Care MCO contract lanauage (page 208) or contact MCO’s directly
Presbyterian Health Plan, Inc.
Health Plan
Recognizes NCQA PCMH
Visit program website or Contact; Joseph Garcia, 505-923-8912, [email protected]
Directory of PCMH Resources and Incentive Programs
Page 40 of 61
New York
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
Delivery System Reform Incentive Payment Program
Medicaid Recognizes NCQA PCMH
Refer to program website, or contact DSRIP Program at [email protected]
New York State Patient-Centered Medical Home (NYS PCMH)
Multi-Payer Mandates NCQA PCMH
Refer to the program website, or contact
Patient Centered Medical Home Incentive Program
Medicaid Mandates NCQA PCMH
* Payment with higher recognition level
Refer to state program page or contact Division of Health Plan Contracting and Oversight at [email protected]
Excellus Health Plan
Health Plan Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to program website
(Empire) Anthem/Enhanced Primary Care Program
Health Plan Recognizes NCQA PCMH
Please contact your Anthem representative.
Adirondack Health Institute (AHI)
Regional Collaborative
Transformation support to help practices achieve
Refer to program website or contact Bob Cawley, Director of Medical Home Initiatives at [email protected]
Directory of PCMH Resources and Incentive Programs
Page 41 of 61
and sustain NCQA PCMH
Optimum Physician Alliance (HealthNow)
Membership Org.
Transformation support to help practices achieve NCQA PCMH and PSCP
Refer to program website or contact directly at [email protected]
Central New York Care Collaborative
Regional Collaborative
Transformation support to help practices achieve and sustain NCQA PCMH
Refer to program website.
New York eHealth Collaborative
REC Transformation support to help practices achieve NCQA PCMH
Refer to program website
The Healthcare Association of New York State
Membership Org.
Transformation support to help practices achieve NCQA PCMH, PSCP, DRP
Refer to program website
OneCity Health Services PPS Transformation support to help practices achieve NCQA PCMH
Refer to organization website or contact [email protected]
Directory of PCMH Resources and Incentive Programs
Page 42 of 61
North Carolina Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Blue Cross Blue Shield of North Carolina
Health Plan
Recognizes NCQA PCMH
* Payment with higher recognition level
Refer to program website. Note that practices can only apply for participation during March and August.
Community Care of North Carolina
Regional Network
Recognizes NCQA PCMH,DRP, HSRP
Refer to program website
Community Care of Western North Carolina
Regional Network
Transformation support to help practices achieve NCQA PCMH or PCSP
Refer to program website
Northwest Community Care Network
Regional Network
Transformation support to help practices achieve NCQA PCMH or PCSP
Refer to program website or call [email protected]
North Carolina Area Health Education Center
Regional Network
Transformation support to help
Refer to program website or contact [email protected]
Directory of PCMH Resources and Incentive Programs
Page 43 of 61
practice achieve NCQA PCMH
Directory of PCMH Resources and Incentive Programs
Page 44 of 61
North Dakota
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Blue Cross Blue Shield of North Dakota
Health Plan
Recognizes NCQA PCMH
Visit program website or Contact Customer support: 1-800-342-4718
North Dakota Department of Health-Children’s Special Health Services (CSHS)
Multi-Payer
Recognizes NCQA PCMH
Visit program overview.
Directory of PCMH Resources and Incentive Programs
Page 45 of 61
Ohio
Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of NCQA
Recognition Resources Learn More
Healthcare Collaborative
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Refer to program website
NewHealth Collaborative
ACO Transformation support to help practices achieve NCQA PCMH, PCSP
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 46 of 61
Oklahoma Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 47 of 61
Oregon Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Oregon Patient-Centered Primary Care Home Program (PCPCHP)
Multi-Payer
Recognizes NCQA PCMH in the form of auto-credit
Refer to program page, Standards for PCPCH Recognition, or email [email protected]
Directory of PCMH Resources and Incentive Programs
Page 48 of 61
Pennsylvania Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
UPMC Health Plan Health Plan Recognizes NCQA PCMH, PCSP, PCCC
* Payment with higher recognition level
Refer to program website or email [email protected]
Pennsylvania Academy of Family Physicians
Membership Org.
Transformation support to help practices achieve NCQA PCMH, PCSP, PCCC, DRP, HSRP
Refer to program website
American Academy of Pediatrics, PA Chapter –Medical Home Initiative
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Refer to program website
Pittsburgh Regional Health Initiative (PA REACH) REC
REC Transformation support to help practices achieve NCQA PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 49 of 61
Puerto Rico Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Ponce School of Medicine
REC PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 50 of 61
Rhode Island Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA
Recognition Resources Learn More
Care Transformation Collaborative
Multi-Payer Mandates NCQA PCMH
Refer to program website
Blue Cross Blue Shield of Rhode Island
Health Plan Mandates NCQA PCMH
Refer to program website
Rhode Island Quality Institute- Center for Improvement Sciences
REC Transformation support to help practices achieve NCQA PCMH
Visit Website of contact org directly at [email protected] or by phone 888.858.4815, Option 5 for more information
Directory of PCMH Resources and Incentive Programs
Page 51 of 61
South Carolina Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
South Carolina Provider Quality Incentive Program (via MCO Contracts)
Medicaid Recognizes NCQA PCMH
Refer to SC Provider Quality Incentive Program language or contact MCO’s directly
Quality through Technology and Innovation in Pediatrics (QTIP)
Medicaid Recognizes NCQA PCMH
Refer to program webpage and learn how to participate
Blue Cross Blue Shield of South Carolina
Health Plan Mandates NCQA PCMH
Refer to program webpage and/or complete and submit interest form
South Carolina Medical Association
Membership Org.
Transformation support to help practices achieve NCQA PCMH
Refer to program webpage
Directory of PCMH Resources and Incentive Programs
Page 52 of 61
South Dakota Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA
Recognition Resources Learn More
Best Practices Academy
Consultant Transformation support to help practices achieve NCQA PCMH
Visit program website.
Directory of PCMH Resources and Incentive Programs
Page 53 of 61
Tennessee Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
TennCare PCMH Program Medicaid Mandates NCQA PCMH
Refer to Provider Operating Manual or contact
Blue Cross Blue Shield of Tennessee
Health Plan Mandates NCQA PCMH
Refer to program brochure or email [email protected]
Directory of PCMH Resources and Incentive Programs
Page 54 of 61
Texas Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Texas Health Care Transformation and Quality Improvement Demonstration (DSRIP Project 2.1)
Multi-Payer Recognizes NCQA PCMH
Refer to Project 2.1 – Enhance/Expand Medical Homes (Page 286)
Superior Health Plan
Health Plan Recognize NCQA PCMH
Refer to contact page
Texas Blue Cross Blue Shield
Health Plan Recognizes NCQA PCMH
Visit program website for more information.
Gulf Coast REC
REC Transformation support to help practices achieve NCQA PCMH
Refer to program website
Directory of PCMH Resources and Incentive Programs
Page 55 of 61
Utah Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition Resources Learn More HealthInsight REC REC Transformation support
services to help practices achieve PCMH
Visit program website for more information.
Directory of PCMH Resources and Incentive Programs
Page 56 of 61
Vermont Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA Recognition
Resources Learn More
Vermont Blueprint for Health Multi-Payer Mandates NCQA PCMH Recognizes NCQA PCSP
* Payment with higher recognition level
Refer to Program Manual Effective June 2017 or contact Beth Tanzman, Assistant Director, BluePrint for Health at [email protected]
Directory of PCMH Resources and Incentive Programs
Page 57 of 61
Virginia Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 58 of 61
Washington Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 59 of 61
West Virginia Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
NCQA is not aware of any public sector, private, or multi-payer initiatives supporting NCQA Recognition program
Directory of PCMH Resources and Incentive Programs
Page 60 of 61
Wisconsin
Current NCQA Recognitions - Report Card and Interactive Map
Organization Type Use of NCQA
Recognition
Resources Learn More
Blue Cross Blue Shield of Minnesota
Health Plan
Requires PCMH for contracted border providers in Wisconsin
Contact your plan representative for more information.
Directory of PCMH Resources and Incentive Programs
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Wyoming Current NCQA Recognitions - Report Card and Interactive Map Organization Type Use of
NCQA Recognition
Resources Learn More
Wyoming PCMH WyHealth Care Management Program
Medicaid Recognizes NCQA PCMH Readiness
Refer to program page or contact Sheree Nall, Program Manager for WyHealth PCMH Care Management Program at [email protected]
