Annual Reporting for PCMH 2021

Under the redesigned PCMH program, health centers will demonstrate annually that they continue to align with recognition requirements. The 2021 annual reporting requirements for PCMH recognition are outlined in the page below (Click here to access).

Practices will also have the opportunity to submit data and documentation on special topics, such as behavioral health and social determinants of health. This piece is not scored for PCMH recognition but NCQA asks that practices submit the information.

NCQA published a video recording providing a brief (20 min.) overview of  the 2020 PCMH Annual Reporting Requirements. Click here to access.

Please Note: The requirements for Annual Renewal in 2021 remain nearly identical to 2020, so this resource still provides a good overview for 2021. This resource will be updated when it becomes available from NCQA.  

Notable changes in 2021

  • In response to the COVID-19 pandemic, NCQA has limited changes to Annual Reporting for 2021. PCMH and PCSP Annual Reporting Requirements for reporting period January 1–December 31, 2021, remain nearly identical to the preceding reporting year.
  • NCQA has expanded and clarified PCMH program guidance for use of telehealth to ensure that practices can continue to meet PCMH requirements. Click here to read NCQA’s recent blog post to learn more.
  • A table of updates summarizing changes to the publications is available in the FAQ section of NCQA.org.  Click here for the PCMH FAQ.
  • The full 25-page detailed 2021 NCQA guidelines and requirements can be viewed below.

NCQA Patient-Centered Medical Home Recognition Annual Reporting Preparation Guide For Reporting Year 2021

This guide (published by NCQA September 2020) will help you navigate the NCQA Patient-Centered Medical Home (PCMH) Annual Reporting process. It explains the process and how it compares to earning initial Recognition, and what you can show NCQA to demonstrate that your practice is still functioning as a PCMH.

This guide contains several tools that will help you stay on track to complete the Annual Reporting process:

  • Annual Reporting Requirements Checklist
  • Major Milestones and tasks for Annual Reporting Checklist
  • Practice GAP Assessment and Improvement Checklist

Please Note: The requirements for Annual Renewal in 2021 remain nearly identical to 2020.

NCQA Annual Reporting Requirements 2021

Explore the document below for full details on the 2021 annual reporting requirements. NCQA annual reporting requirements will change year over year – updates will be available within six months before they are scheduled to take effect. Note that practices should submit the version of the annual reporting requirements that is of the same year as their renewal/anniversary date (e.g. If a practice is due in February 2021, they should report according to the 2021 requirements.).

NCQA will also ask for a completed QI Worksheet (2021 version), as mentioned in the above PDF outlining requirements for sustaining PCMH recognition.

Accepted Quality Measures

NCQA maintains a list of measures accepted as a future part of, or alternative to, the annual reporting process.

Quality Measures Crosswalk
This document represents a crosswalk chart of the quality measures that NCQA will include in its PCMH recognition program. It provides a crosswalk among the measures that are used to support HEDIS reporting, as well as to support payment incentive programs such as MACRA. In addition, the chart identifies the measures that NCQA offers certification to vendors seeking validation that their quality measures reporting capabilities meet the CMS reporting specifications. This list will be updated periodically.