Some specialists considered applying for patient-centered medical home status, but found it didn't make sense, since one wouldn't expect an oncologist, for example, to be keeping tabs on the patient's diabetes treatment or other unrelated specialty work.
So the new guidelines make it clear that the specialists should continue to provide their specialty care, but these guidelines close that loop I described by requiring certified specialists to indeed report back to the referring primary care practices.
Specialty Practice Recognition 2013 will replace the Physician Practice Connection guidelines published by NCQA in 2006. Back then, NCQA had not yet issued the original patient-centered medical home guidelines, so it is high time for revisions.
The latest NCQA moves draw upon work done by the American College of Physicians (ACP) and the Agency for Healthcare Research and Quality (AHRQ), including AHRQ's 2011 white paper, "Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms." It's well worth reading for a variety of ideas on how to enhance care coordination. For instance, the paper mentions the importance of strong community linkages that include both clinical and nonclinical services, such as personal care services, home-delivered meals, or school-based health care.