Which agencies certify PCMHs?

• A. National Committee for Quality Assurance
• B. Utilization Review Accreditation Commission
• C. Joint Commission
• D. CMS

Answer: (A)

Certification of a Patient-Centered Medical Home is primarily handled by the National Committee for Quality Assurance (NCQA). NCQA created and maintains the PCMH Recognition program, which sets specific standards across domains such as access to care, team-based care, care coordination, patient-centered processes, comprehensive health maintenance, and ongoing quality improvement. When a practice meets these standards, NCQA awards recognition that many payers and government programs use to identify PCMHs and tie them to incentive payments and value-based arrangements. That widespread use by payers for credentialing and reimbursement is what makes NCQA the go-to certifier for PCMHs.

The other organizations have different roles: the Joint Commission focuses on accrediting hospitals and various facilities, not specifically certifying clinics as PCMHs; CMS is a payer and administrator of payment models that may reward PCMH-like care but does not certify practices as PCMHs; and URAC offers broad health care accreditation but is not the primary certification body for PCMH recognition.