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NJAFP Congratulates 32 Practices That Achieve NCQA PCMH Medical Home Recognition With Assistance of NJAFP Through Innovative Pilot Project

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The New Jersey Academy of Family Physicians (NJAFP) is pleased to announce that 32 practices participating in the NJAFP/Horizon Blue Cross Blue Shield of New Jersey (Horizon) Patient-Centered Medical Home (PCMH) Recognition Pilot Project, have received national PCMH recognition from NCQA. These practices represent 63 individual practice sites and 167 Family Physicians and other primary care doctors actively participating in the NJAFP/Horizon project, which began in April 2009.  "This is a major accomplishment for the practices. The practices in our project worked with us and dedicated the time and resources needed to begin the journey of transforming their practices to this patient-centered care model. The hard work by everyone involved allowed the practices to achieve national PCMH recognition in about four months, which is truly amazing," states Ray Saputelli, Executive Vice President, NJAFP.

The core goal of the NJAFP project is to support primary care practices as they begin to transform traditional office-based care from an acute episodic care model to the PCMH model. The PCMH is a model of carecoordinated by the primary care physician office, where healthcare professionals work as a team to provide care that is individually determined to meet each patient's specific need. This approach fosters an environment in which patients develop and maintain an ongoing relationship with their primary care physician and a healthcare team who focus on enhanced care coordination and office-based disease management planning. As such, the practice becomes the patient's "home" for preventive, chronic, and ambulatory care.

Practices participated in an NJAFP-developed and -directed educational program, which focused on assisting practices demonstrate that they meet nationally recognized NCQA PCMH standards. A practice participating in the Pilot Project voluntarily submitted documents to NCQA showing that it met NCQA PCMH standards. NCQA reviewed the practice's submitted documents and determined if the practice met or exceeded its standards. When NCQA determined that a practice was operating within these standards, the practice received recognition. NCQA is a well-respected, non-profit organization that has been a central figure in driving improvement throughout the healthcare system since its founding in 1990. Practices that achieved national NCQA PCMH recognition worked with NJAFP to demonstrate the practice is able to:


  • Provide access during and after business hours and communicate effectively with patients
  • Use readily accessible, clinically useful information to assist in comprehensive care
  • Collaborate with patients and families to pursue goals for optimal achievable health
  • Improve effectiveness of care, safety, and efficiency by accessing timely information for tests and results, measuring and reporting performance, giving physicians regular feedback, and taking actions to improve, and maximizing use of electronic communications to facilitate coordination of care


According to the Commonwealth Fund, a practice that implements the PCMH model of care, can decrease, and in some cases eliminate, disparities in access and quality. When adults have a PCMH, their access to care, utilization of preventive services, and management of chronic conditions improve dramatically. The Fund also found in the United States, when primary care physicians effectively manage care, adults with conditions such as diabetes, congestive heart failure, and asthma have fewer complications, resulting in fewer hospitalizations. The Commonwealth Fund also reports that Denmark has structured its entire healthcare system around medical homes, resulting in the highest patient satisfaction ratings in the world. Among Western nations,Denmark has among the lowest per capita health expenditures.

Care provided by primary care physicians in a PCMH is consistently associated with better outcomes, reduced mortality, fewer preventable hospital admissions for patients with chronic diseases, lower utilization, improved patient compliance with recommended care, and lower Medicare costs.


For a complete list of PCMH Recognized practices in NJ, click on the following link: