Quality Corner: Patient-Centered Primary Care Home 2025 Recognition Criteria

Medical Home recognition is an LHP membership requirement for primary care practices. Recognition signifies to patients and payors that our clinicians are committed to providing high quality care that is accessible, accountable, comprehensive, continuous, coordinated and patient and family centered.

LHP practices who meet this requirement through Oregon Health Authority’s Patient-Centered Primary Care Home (PCPCH) recognition program will soon be held to revised criteria. Practices must re-apply for recognition every two years. Beginning January 1, 2025, practices applying or re-applying will be required to meet the 2025 PCPCH model standards (to be released March 30, 2024).
We recommend any practices due for re-application in 2024 not delay, so they can re-apply against the current criteria. Practices due for re-application in 2025 and beyond should begin looking at the new criteria when they become available at the end of this month so they may begin implementing any changes necessary to maintain recognition.

Highlights of these changes include:

Three new must-pass measures

  • 4.F.0 - PCPCH has a process for reassigning administrative requests, prescription refills, and clinical questions when a provider is not available.
  • 6.D.0 - PCPCH has a written document or other educational materials that outlines PCPCH and patient rights, roles, and responsibilities and has a system to ensure that each patient, family, or caregiver receives this information at the onset of the care relationship.
  • 6.E.0 - PCPCH assures that its staff is trained in delivering culturally and linguistically appropriate, trauma-informed, or trust-building care.

Three new standards

  • Value-based payment (VBP) standard with optional measures.
  • Healthcare cost transparency and navigation standard with optional measures.
  • Building a culturally responsive workforce standard with a must-pass measure (see 6.E.0 above).

Addition of a new Health Equity Designation
for practices who would like to highlight their prioritization of supporting health equity. This designation is available for practices achieving any tier of recognition who have attested to, and provided documentation for, meeting 15 of the 20 health equity focused measures.

Changes in tier levels and point distribution. Tier levels available are limited to tier 3 (100-245 points), tier 4 (250-390 points), and tier 5 (395-530 points). Practices must meet all 13 must-pass measures to achieve any tier.