My research convinced me that this movement is still in its infancy. Not many physician practices have yet achieved NCQA certification as patient-centered medical homes. One sole practitioner I interviewed said the paperwork required is daunting for a small practice. But over time I expect this situation to improve.
NCQA rightly recognizes that continuity of care requires a closed loop of preserved information from primary practices to specialists and back again. And that requirement hasn't been there in the NCQA certification—until now.
Repeatedly, NCQA officials have heard it's been a one-way street, where referrals flow from the patient-centered medical homes to the specialists, but the specialists are under no obligation to respond back post-referral, leaving the primary care providers to wonder if the referral was received and what became of it.
In an Archives of Internal Medicine article, "Referral and Consultation Communication between Primary Care and Specialist Physicians," the authors found that primary care physicians reported sending the history or reason for consult information nearly 70% of the time, while specialists reported receiving such information only close to 35% of the time. Meanwhile, specialists claim to have sent consult notes or patient advice nearly 81% of the time, while PCPs claim receipt only 62% of the time.