Congratulations! You've achieved PCMH recognition. But the work is far from over. What do you have to look forward to now? Annual Reporting! This can be a daunting task and it is important to know all the details. Here, we will cover exactly what NQCA PCMH Annual Reporting (AR) is, timeline and steps, review required vs. optional reporting elements, and more.
What is Annual Reporting?
Annual Reporting (AR) is the maintenance of PCMH recognition, also known as the Sustaining Phase. Practices have the flexibility to choose certain optional criteria based on your practice and population. Although reporting is required annually for PCMH 2017 practices or current PCMH 2014 Level 3 recognized practices, the reporting process contains a more simplified process with less paperwork and provides the ability to demonstrate continuous, data-driven quality improvement. AR engages practices to check in and confirm continuous commitment to patient-centered activities and performance, while ensuring that changes implemented during the initial recognition are ingrained in operational culture.
How to prepare
PCMH 2017 recognized practices need to:
- Review annual reporting requirements
- Ensure ongoing compliance with 2017 Core Criteria activities
- Identify and select submission options
- Create a work plan
PCMH 2014 Level 3 recognized practices need to:
- Review PCMH 2017 Standards and focus on Core Criteria
- Ensure compliance with the PCMH 2017 Core Criteria
- Identify and select submission options
- Create a work plan to ensure compliance and Annual Reporting success
Annual Reporting Requirements for PCMH Recognition
Annual Reporting - Reporting Period January 1 - December 31, 2020
| AR-TC 01 Patient Care Team Meetings |
| AR-KM 01 Proactive Reminders |
| AR-AC Must report both: AR-AC 1 Access Needs & Preferences and AR-AC 2 Access for Patients After Hours |
| AR-CM Must report both: AR-CM 1 Identifying & Monitoring Patients for Care Management and AR-CM 2 Care plans for Care Managed Patients |
| AR-CC Must report all three: AR-CC 1 Care Coordination Process AR-CC 2 Referral Management Process, and AR-CC 3 Care Coordination with Other Facilities Process |
| AR-CC Must chose to report one: AR-CC 4 Lab/Imaging Test Tracking, or AR-CC 5 Referral Tracking |
| AR-QI Must Report all four: AR-QI 1 Clinical Quality Measures, AR-QI 2 Resource Stewardship Measures, AR-QI 3 Patient Experience Feedback, and AR-QI 4 Monitoring Access |
| AR-QI Required to report, but not scored: AR-QI 5 ECQM's and AR-QI 6 Value Based Payment agreement |
| AR-SD Required to report, but not scored: AR-SD 1 Collection & Assessment of SDoH data, AR-SD 2 Use of Care Interventions & Community Resources Assessment, and AR-SD 3 Care Interventions & Community Resources Assessment |
Timeline for Annual Reporting
You might be wondering when you need to begin this process. Annual Reporting Data is due 30 days prior to your recognition date. For example, if your recognition date is 8/9/20, your data would be due no later than 7/6/20. The timeline steps may vary year to year since NCQA updates the AR Standards annually. They are typically released the July prior to the reporting year. For example, 2021 AR standards would be released in July of 2020.
Recommended work plan:
- Review Standards six to nine months prior
- Self-assess and/or begin choosing optional criteria and preparing data
- Recommend requesting NOI in EHB six months prior to reporting timeline
- Complete QPASS set up and validate clinicians
- Submit data for Annual Reporting by Reporting Date (30 days prior to lapse)
Keys to ongoing success
Since PCMH Annual Reporting is a necessary step for all recognized practices, it is always a good idea to keep up with the process. Each year practices should review and plan to attest or submit data based on the updated standards. As part of the Sustaining Phase, a practice is considered transformed. Each practice should continue to follow the PCMH model and activities and embrace continuous quality improvement.
Additional resources: