Date Approved

4-17-2023

Graduate Degree Type

Project

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Sylvia Simons, MSN, DNP, RN

Second Advisor

Marie VanderKooi, MSN, DNP, RN

Academic Year

2022/2023

Abstract

Background: The Patient Centered Medical Home (PCMH) is a model of healthcare designed to improve health outcomes, decrease costs, and increase quality of care.

Local Problem: A Nurse Managed Health Center (NMHC) was pursuing PCMH designation through the National Committee for Quality Assurance (NCQA). However, it was determined that the costs to attain NCQA PCMH designation were prohibitive and the NMHC wanted to seek other options for PCMH designation.

Methods: A crosswalk of NCQA competencies and Blue Cross Blue Shield (BCBS) capabilities was completed to determine the feasibility of switching to BCBS PCMH designation.

Interventions: Policies and procedures were created to meet BCBS capabilities. A toolkit was created that included evidence to show capabilities met.

Results: The NMHC achieved all required BCBS capabilities and exceeded the minimum elective capabilities needed for BCBS PCMH designation. Also, it was determined that BCBS has better cost savings for patients.

Conclusions: This project can be adapted to other primary care settings.

Available for download on Sunday, April 19, 2026

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