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What NCQA Recognition Means for Patients With Diabetes

Robert A. Gabbay, MD, PhD, FACP
Joslin Diabetes Center has earned the highest level of recognition from the National Committee for Quality Assurance, which cited the center's strengths in communication, access, and coordination of care in the citation for a Patient-Centered Specialty Practice.
In January, just as the previous issue of Evidence-Based Diabetes Management was going to press, Joslin Diabetes Center received important news that I am proud to share: Joslin has earned the highest level of recognition from the National Committee for Quality Assurance (NCQA) as a Patient-Centered Specialty Practice (PCSP).
 
The PCSP designation is modeled on and complements NCQA’s Patient-Centered Medical Home (PCMH) Recognition Program. Many of you in primary care are familiar with the Medical Home model; it uses the concept of teamwork to improve the patient experience, takes a population-based approach to manage those in the practice with risk stratication, proactive care and outreach for those in need, and has been shown to improve outcomes in a variety of different primary care settings.
 
The PCSP recognition highlights the rest of the continuum of specialists (“Neighbors of the Medical Home”) that are needed to provide outstanding diabetes care. It is clear for diabetes, as much as for any chronic disease, that optimal care requires a team-based approach: primary care providers, endocrinologists, ophthalmologists, nephrologists, diabetes educators, dietitians, and a broad coordinated neighborhood are needed to achieve optimal results. The “neighbors” of medical specialties are those that surround and inform the medical home and colleagues in primary care.
 
Being recognized for providing quality care is always good news, but this news truly sets us apart. “Three-level” recognition by the NCQA as a Patient-Centered Specialty Practice (PCSP) means that Joslin was cited for its responsiveness both to patients and to medical colleagues, for its cooperation with healthcare groups, and for its dedication to continuous improvement. NCQA’s standards are well recognized, as the organization is celebrating its 25th year of working to improve healthcare quality by providing both standards of measurement and transparency for the benet of providers and consumers.
 
For patients with diabetes, knowing that a healthcare provider is responsive to others is exceedingly important. Much of the challenge of living with diabetes involves dealing with “the system” and its many moving parts, which at times seem incapable of working together on one’s behalf. That’s why PCSP recognition is so special.
 
The thinking behind both models is simple: adapt the care to the patient, instead of expecting the patient to adapt to the care. In diabetes care, especially, we ask so much from our patients. Persons with type 1 diabetes mellitus (T1DM) typically check their blood sugar several times a day, and they have to take insulin. Those with type 2 diabetes mellitus (T2DM) may take a host of medications, including insulin. There are challenges to focusing on a healthy meal plan and exercise. We ask patients to follow up on referrals to eye or foot specialists and then they need to coordinate care across the many providers, often spread across different health systems.  
 
Everyone at Joslin is proud to have met or exceeded national standards for:
 
• Communicating with primary care clinicians to exchange key information and establish coordinated care plans
• Providing timely access to care and clinical advice based on patient need
• Using a systematic approach to track referrals and coordinate care
• Measuring and improving performance over time.
 
The last measure is especially important, because we must constantly monitor our quality of care, not just to keep up current standards but also to seek new ways to improve delivery, either through better technology or through feedback we get from patients and families.
 
Notice how much of this designation involves the mechanics of how we provide care—coordination, tracking, referring. These are the components that make up the patient experience. As important as it is to have groundbreaking clinical research, to have the people who will one day nd a cure for diabetes, it is essential that we do all we can to make care as seamless as possible for those who must live with this disease today. Doing a better job of coordinating care, of making sure referrals are properly tracked, of making sure that patients receive follow-up care—all these things produce results such as better glycemic control, fewer complications, and fewer days in the hospital or the emergency department. And that’s the ultimate goal of patient-centered care.
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