Introduction to PCMH: Heartland Health Alliance

July 27, 2021

8:30 am - 5:00 pm CST. 
9:30 am -6:00 pm EST.


Introduction to PCMH: Foundational Concepts of the Medical Home

This training is organized exclusively for the Heartland Health Alliance and their learners.

This program is designed as an introductory course for anyone interested learning the fundamentals of the PCMH Recognition program. The course covers the basic topics of PCMH including the core attributes of patient-centered medical homes, the required evidence and determining how to present it as well as the processes and procedures that demonstrate transformation into the medical home model.

Target Audience

This program is designed for any health care professional, health care decision maker or consultant interested in getting the inside perspective directly from expert faculty from NCQA in evaluating a primary care practice and their ability to become Recognized as a Patient-Centered Medical Home by NCQA.

Learning Objectives

At the conclusion of the webinar, participants will be able to:

  •     Identify the core attributes of patient-centered care
  •     Identify supporting evidence and determine how to present it
  •     Describe processes and procedures that demonstrate transformation into
        the medical home model
  •     Work with an assigned NCQA representative on a plan to earn recognition
  •     Examine the more challenging aspects of the requirements in a variety
        of practice environments


Course summary
Available credit: 
  • 6.00 AAPA
  • 6.00 ACPE
  • 6.00 AMA PRA Category 1 Credit™
  • 6.00 ANCC
  • 6.00 APA
  • 6.00 ASWB
  • 6.00 IPCE
  • 1.00 Participation
  • 6.00 PCMH CCE
Course opens: 
Course expires: 
Event starts: 
07/27/2021 - 9:30am EDT
Event ends: 
07/27/2021 - 6:00pm EDT

Tuesday, July 27

Times listed in Central Time

8:15 a.m. – 8:30 a.m.Pre-Event Zoom Log-In
8:30 a.m. – 8:40 a.m.

Welcome & Introduction of Faculty

  • Brenda Lamb
    Rural Division Improvement Officer, Bryan Health


NCQA Faculty:

  • Sarah Lee, PCMH CCE
    Assistant Director, Recognition Policy
  • Bri Clifford, MPH, PCMH CCE
    Senior Manager, Recognition Policy
  • Jennifer Anglin, MS, CHES, PCMH CCE
    Manager, Recognition Policy
8:40 a.m. – 9:05 a.m.

Background of the Patient-Centered Medical Home (PCMH) Recognition Program

  • About NCQA
  • Eligibility Requirements

Sarah Lee

9:05 a.m. – 9:30 a.m.

Highlight and Discuss Key Components of the PCMH Program

  • Concepts, Competencies, Criteria
  • Core and Elective Criteria

Bri Clifford

9:30 a.m. – 10:00 a.m.

Commit Process & Transformation Process

Jennifer Anglin

10:00 a.m. – 10:15 a.m.Break
10:15 a.m. – 10:45 a.m.

Succeed in PCMH Recognition

  • Annual Reporting Requirements

Sarah Lee

10:45 a.m. – 10:55 a.m.

Scoring: Fact or Fiction?

Bri Clifford

10:55 a.m. – 11:30 a.m.

Discuss and Analyze the PCMH Recognition Requirements

  • Team Based Care and Practice Organization

Bri Clifford

11:30 a.m. – 12:00 p.m.

Discuss and Analyze the PCMH Recognition Requirements

  • Knowing and Managing Your Patients (A-B)

Jennifer Anglin

12:00 p.m. – 12:30 p.m.Lunch (On Your Own)
12:30 p.m. – 1:30 p.m.

Discuss and Analyze the PCMH Recognition Requirements

  • Knowing and Managing Your Patients (C-F)

Sarah Lee

1:30 p.m. – 2:00 p.m.

Discuss and analyze the PCMH Recognition Requirements

  • Patient-Centered Access and Continuity

Bri Clifford

2:00 p.m. – 2:35 p.m.

Discuss and analyze the PCMH Recognition Requirements

  • Care Management and Support

Jennifer Anglin

2:35 p.m. – 2:45 p.m.Break
2:45 p.m. – 3:30 p.m

Discuss and analyze the PCMH Recognition Requirements

  • Care Coordination and Care Transitions

Sarah Lee

3:30 a.m. – 4:15 p.m.

Discuss and Analyze PCMH Recognition Requirements

  • Performance Measurement and Quality Improvement

Bri Clifford

4:15 p.m. – 4:45 p.m

PCMH Return on Investment (ROI)

Jennifer Anglin

4:45 p.m. – 5:00 p.mQ&A Regarding Content Addressed During the Seminar & Conclusion

*schedule is subject to change without notice

Jennifer Anglin, MS, CHES,  PCMH CCE
Jennifer Anglin is a Manger of Recognition Policy at NCQA. Her responsibilities include creation and maintenance of PCMH resources and providing support to practices going through transformation or annual review. Prior to NCQA, Jennifer worked for Purdue University by assisting practices throughout the state of Indiana on quality improvement and research projects as well as supporting them to meet Medicaid’s Promoting Interoperability program and Medicare’s MIPS program. Jennifer’s professional interests include health policy, research, and education. She has a particular interest in social determinants of health and the behavioral health aspect of Patient-Centered Medical Homes.  

Jennifer holds a BA in secondary education from Valparaiso University and a master’s degree in health science from Indiana State University. Jennifer is a Certified Health Education Specialist and has been a NCQA Patient-Centered Medical Home Certified Content Expert (PCMH CCE) since 2013.


Bri Clifford, MPH, PCMH CCE
Bri Clifford is a Senior Policy Manager in NCQA’s Recognition Programs Policy and Resources Department. On this team she supports recognition programs through the creation of resources, maintenance of programs and education of both internal and external stakeholders.

Before joining NCQA, she worked with the United States Department of Health and Human Services Office of Emergency Management. There she helped create a GIS mapping tool used to track patient movement to HHS staffed medical facilities in response to natural disasters. She also spent three years managing the clinical side of specialty practices and volunteering as an EMT in her community.

Bri holds a BS in Biology from Virginia Tech and an MPH in Epidemiology from George Mason University.


Sarah Lee, PCMH CCE
Sarah Lee has been with NCQA since 2012 and is the Assistant Director of Recognition Programs Policy and Resources. She supports the development, maintenance and update of NCQA’s practice-level recognition and state-specific programs. She also provides internal staff and external customers with the resources needed to clearly understand recognition program processes and requirements. Prior to this role, she was a manager of Government Recognition Initiatives where she oversaw the review process for federal qualified health centers and military facilities pursuing NCQA recognition. 

Sarah graduated from the University of California, San Diego with a BA in International Studies, Economics. She received her MPA with a focus on Policy Analysis and Evaluation from The George Washington University in Washington, DC.



In support of improving patient care, the National Committee for Quality Assurance is jointly accredited for Continuing Medical Education (ACCME), the  American Nurses Credentialing Center (ANCC), the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), and the Association of Social Work Boards (ASWB) to provide Interprofessional Continuing Education for the healthcare team. 

This educational activity is approved for: 6.0 AMA PRA Category 1 CreditTM, ANA CNE, AAPA, APA, and ASWB ACE contact hours.*

The assigned universal program number: JA0004597-0000-21-008-L04-P. Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit.

This program grants 6.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  This program is not considered a required CCE quarterly webinar.

* Please note – You must attend the entire program to be eligible for total number of contact hours. 

Available Credit

  • 6.00 AAPA
  • 6.00 ACPE
  • 6.00 AMA PRA Category 1 Credit™
  • 6.00 ANCC
  • 6.00 APA
  • 6.00 ASWB
  • 6.00 IPCE
  • 1.00 Participation
  • 6.00 PCMH CCE
Please login or register to take this course.

Required Hardware/software

We recommend using either Google Chrome or Mozilla Firefox as your browser for the optimal experience with the NCQA Education learning management system.