NCQA’s Patient-Centered Specialty Practices coordinate care beyond the medical home

APA supports mental and behavioral health services in the National Committee for Quality Assurance’s new coordinated care program.

By Legal & Regulatory Affairs staff

April 25, 2013–The National Committee for Quality Assurance (NCQA) recently launched a Patient-Centered Specialty Practice (PCSP) Recognition program. This program recognizes specialty practices, including mental health practices, that can demonstrate successful care coordination. Goals of the PCSP include improved coordination and communication between specialty and primary care, timely access to services, continuous quality improvement and involvement of the patient or caregiver in managing care. 

The APA Practice Directorate submitted comments during the development phase of the PCSP program supporting the goals of enhancing communication and coordination between specialist care and primary care providers. In addition, we recommended specific changes to the proposed standards to ensure that psychologist-led practices, including small mental health practices, would be eligible. 

Although many of APA’s specific suggestions were not followed, our main concerns were addressed. The program standards and policies now contain language that clearly allows for participation by psychologists. For example, the PCSP Policies and Procedures, Section 1, includes the following:

  • Psychologists are specifically listed among the eligible clinicians. 

  • “Practices” are defined as “One or more clinicians who practice together and provide patient care at a single geographic location…” 

  • Behavioral health care practices without a physician can earn NCQA recognition.

The PCSP program builds on the same concepts as NCQA’s widely adopted Patient-Centered Medical Home (PCMH) Recognition program. When NCQA released its updated PCMH standards in 2011, it highlighted a “stronger focus on integrating behavioral health care and care management.” Both the PCSP and PCMH standards align with many elements of the federal program that reward clinicians for using health information technology (HIT). Answers to frequently asked questions about PCSP, including questions about HIT, are available on the NCQA website.

The PCSP can be seen as part of the “medical neighborhood” that surrounds the medical home. These concepts have been described in publications such as the Agency for Healthcare Research and Quality white paper on Coordinating Care in the Medical Neighborhood and the American College of Physicians position paper on The Patient-Centered Medical Home Neighbor (PDF, 301KB). 

Psychologists and other mental health professionals can provide services that are essential to integrated care by being a part of the medical neighborhood in either a medical home or as a “neighbor” in a specialty practice. 

NCQA is a private, not-for-profit organization that develops quality standards and performance measures and provides accreditation, certification and recognition programs for health care providers and organizations. According to the NCQA, it accredits health plans covering 107 million Americans. NCQA PCSP program information, access to standards and surveys and additional resources are available on the Patient Centered Specialty Practice Recognition website.

For more information, contact the Legal and Regulatory Affairs department by email or at (202) 336-5889.