Patient-Centered Medical Home recognition is not a document exercise, although it produces a lot of documents. It is a set of workflows: how patients get same-day access, how the team tracks referrals and results, how the practice measures itself and acts on the numbers. Recognition follows when those workflows exist and can be shown.
Revelrex works with practices anywhere in the United States, whether the program is national NCQA recognition or a state or payer variant. We assess where you are, help redesign what needs to change, organize the evidence and support the submission and review.
Practices that benefit
- Primary care, family medicine, internal medicine and pediatric practices seeking first-time recognition.
- Recognized practices rebuilding their medical home workflows after a lapse or a change of ownership.
- Practices asked by a payer or ACO to achieve recognition within a deadline.
- Groups standardizing medical home workflows across several sites.
What usually goes wrong
Not knowing where you stand
Practices often do many of the right things but cannot map them to the criteria, so they either over-prepare or discover gaps late.
Evidence scattered everywhere
Policies in Word, reports in the EMR, screenshots in email. Assembling it under deadline pressure is where most projects stall.
Workflows that exist on paper only
A referral tracking policy that staff do not follow will not survive a reviewer's questions or, more importantly, will not help patients.
A deadline set by someone else
A payer or ACO contract that requires recognition within a year leaves no room for a stalled project.
The actual work
Readiness assessment
A structured review of your current workflows, policies, EMR capabilities and data against each concept and competency.
Gap assessment
A written gap list ranked by effort and impact, with the recommended path to close each one.
Workflow review and redesign
Access and continuity, team-based care, care management, care coordination, performance measurement and quality improvement: we work with your team on the workflows that need to change and how to document them.
Policy and process support
Templates and drafting help for the policies and procedures the program expects, written to match what your practice actually does.
Evidence organization
A single evidence library mapped to each criterion, with reports, screenshots and documents named and dated the way reviewers expect.
Recognition preparation and submission support
We prepare the submission in the program's platform, review it with you and support responses to reviewer questions.
Review preparation
Preparation of your team for the virtual review, including which staff should speak to which workflows.
Handover to annual reporting
After the decision, we set up the annual reporting calendar and the evidence habits that keep recognition, and offer the separate PCMH Annual Review service for each cycle.
What is included
- Readiness assessment, gap assessment, workflow redesign sessions, policy templates, evidence library, submission preparation, review preparation and support through the decision.
- Annual reporting calendar and evidence habits set up after recognition.
Not included
- NCQA, Q-PASS or other recognition program fees (paid directly by the practice).
- EMR configuration performed by your vendor.
- Ongoing care management staffing.
- NCQA, Q-PASS and other third-party program fees. EMR configuration work performed by your vendor. Clinical staffing changes.
What your practice needs to provide
- A practice champion (usually a physician or practice manager) with time for weekly working sessions.
- Access to the EMR reports and the recognition program account.
- Willingness to change workflows where the assessment shows they do not meet the intent of a criterion.
- Payment of third-party program fees.
Step by step
- 1
Assess
Readiness and gap assessment completed within the first three weeks.
- 2
Plan
Agreed work plan with owners and dates for each gap.
- 3
Transform
Weekly working sessions on workflows, policies and measurement.
- 4
Evidence
Evidence library built and reviewed criterion by criterion.
- 5
Submit and review
Submission prepared, reviewer questions answered, review meeting prepared.
What you receive
Readiness and gap assessment report.
Work plan and workflow documentation.
Complete evidence library mapped to criteria.
Submitted recognition package and support through the decision.
Add PCMH to your Service Cart
A written proposal follows within two business days.
Frequently asked
How long does PCMH transformation take?
Most practices that commit to weekly sessions are ready to submit in four to nine months, depending on how many workflows need to change and how quickly evidence can be generated from the EMR.
Is recognition guaranteed?
No. The recognizing body makes the decision. Our role is to make sure your workflows meet the intent of the criteria and your evidence shows it clearly.
Do you only work with practices in one state?
No. Revelrex supports practices across the United States. Where a state or payer program has additional requirements, we include them in the gap assessment.
We are already recognized. Do we need Transformation?
No. Recognized practices use the separate PCMH Annual Review service, which prepares the annual reporting evidence and confirms the workflows are still in place.
Can our EMR produce the reports needed?
Most certified EMRs can, with configuration. The readiness assessment identifies which reports exist, which need setup by your vendor, and which can be produced another way.