The National Committee for Quality Assurance (NCQA) establishes quality standards and guidelines for health plans, providers, and practices with a mission of improving the quality of health care. NCQA conducts various programs, including but not limited to measure development for the Healthcare Effectiveness Data Information Set (HEDIS), accreditation, credentialing, and recognition programs. One of the most well-known recognition programs distinguishes a practice as a patient centered medical home (PCMH). There are 3 PCMH level designations. 

According to the Agency for Healthcare Research and Quality (AHRQ), a PCMH is a model of the organization of primary care that delivers the core functions of primary health care.¹ They are also often called medical homes, primary care medical homes, medical neighborhoods, advanced primary care practices, and patient-centered health care homes. In adopting the PCMH model, primary care practices transform their practice to integrate the following functions.

“Pay-for-performance (P4P) is an umbrella term for initiatives aimed at improving the quality, efficiency, and overall value of health care.”¹ It is a term involving payment models that tie reimbursement to metric-driven outcomes, practice guidelines, and patient satisfaction in order to improve the overall quality and value of health care. There are numerous quality metrics that can be utilized, with the majority spanning across 4 domains: patient/caregiver experience, care coordination/patient safety, preventive health, and at-risk populations. The metrics used are publically reported, creating transparency and further incentivizing organizations to protect and strengthen their reputations. Both the Centers for Medicare and Medicaid Services (CMS) and commercial payers have created P4P models in order to play a role in the national strategy to transition health care to value-based medicine.

The Pharmacy Quality Alliance (PQA) is an independent, nonprofit national organization dedicated to improving medication safety, adherence, and appropriate use. A measure developer, researcher, educator and convener, PQA’s quality initiatives support better medication use and high-quality care.

The Plan-Do-Study-Act (PDSA) cycle is a continual, four-step model that is used in quality improvement efforts in order to test change.¹