New York State Patient-Centered Medical Home (NYS PCMH)

On April 1, 2018 The New York State Department of Health (NYSDOH) released an innovative model for primary care transformation known as the New York State Patient-Centered Medical Home (NYS PCMH). New York State collaborated with the National Committee for Quality Assurance (NCQA), creator of the patient-centered medical home (PCMH) program to develop this exclusive transformation model for all eligible primary care providers in New York State. NYS PCMH will expand access to high-performing primary care which is key to improving value in health care and achieving the Triple Aim goals of improved health, better health care and consumer experience, and lower cost.

This model was designed as the optimal solution to meet the needs of New York State, including verifiable progress over time, transition from a focus on processes to one that centers on outcomes and performance as well consistency of financial and technical support. The complexity generated by multiple active primary care transformation programs in the State has been an ongoing challenge to achieving objectives sought by NYSDOH. NYS PCMH seeks to combine transformation activities under one umbrella with a uniformed approach of improving primary care across New York State.

About PCMH

The Patient-Centered Medical Home is a model of care that puts patients as the primary focus of care. PCMHs build better relationships between people and their clinical care teams. Research shows that they improve quality, the patient experience and staff satisfaction, while reducing health care costs.

NCQA's Patient-Centered Medical Home Recognition Program is the most widely adopted Patient-Centered Medical Home evaluation program in the country. More than 12,000 practices (with more than 60,000 clinicians) are recognized by NCQA. And more than 100 payers support NCQA recognition through financial incentives or coaching.

Practices that earn recognition through NCQA have made a commitment to providing quality improvement within the practice and a patient-centered approach to care that results in patients that are happier and healthier


The New York State Patient-Centered Medical Home (NYS PCMH) Recognition Program is built upon the NCQA PCMH model. The NYS PCMH Recognition Program is exclusive to New York State. NYS PCMH supports the state's initiative to improve primary care and promote the Triple Aim: better health, lower costs and better patient experience.

  • Transformation Assistance. During its State Innovation Model grant, New York state contracted with 15 organizations that specialized in NYS PCMH to provider transformation assistance free of charge. Many of these organizations still provide assistance to those looking to achieve or retain NYS PCMH recognition. You can find a list of these Transformation Assistance Contractors and their contact information on the NYSDOH web site.
  • Enhanced reimbursement opportunities. Practices that participate in NYS PCMH transformation may be eligible to receive supplemental payments through state programs such as the Medicaid PCMH Incentive Program. For list of Medicaid Update Articles on PCMH initiatives in Medicaid please see PCMH under the topic directory.

For more information on how to enroll in NYS PCMH please visit NCQA's website.

Additional Information & Resources for NYS PCMH

Resources for Recognition

Previous Communication & Marketing Materials

The following materials were created during the Statewide Innovation Model (SIM) grant, or include historical information about the PCMH Recognition process. Materials may contain information which is no longer accurate. If you have questions concerning NYS PCMH, please contact NCQA directly or email

Patient Centered Medical Home Quarterly Reports

These reports provide snapshots of the PCMH program by quarter and give an illustration on how the program changes over time. These reports have four sections:

  1. Practice Information: includes the number of PCMH-recognized practices in the state by recognition level
  2. Provider Information: includes the number of PCMH-recognized providers in the state by recognition level
  3. Enrollee Information: includes counts of NYS Medicaid enrollees who see PCMH-recognized primary care providers
  4. Fiscal Information: includes the amount spent on PCMH by NYS Medicaid through increased capitation rates to recognized providers and fee-for-service 'add-ons' for qualifying visits with recognized providers

Medicaid PCMH Statewide Incentive Payment Program

Patient Centered Medical Home Initiative in New York State Medicaid

This section contains annual reports to the Governor and the Legislature which describe the Adirondack Medical Home Demonstration and Statewide Patient Centered Medical Home programs that New York State Medicaid is participating in, as well as information on program trends, evaluation results, and accomplishments

Patient Centered Medical Home Satisfaction with the Experience of Care

In 2013, a survey was administered to Medicaid Managed Care members to review and evaluate their experiences, and the quality of care they received from PCMH recognized providers, and compared them to the member experiences that received care from non-PCMH recognized providers. The instruments used were the Adult and Child SAHPS Clinician, and Group PCMH surveys. Reports are available below:

Patient Centered Medical Home Medicaid Update Articles

For list of Medicaid Update Articles on PCMH initiatives in Medicaid please see Patient Centered Medical Home (PCMH) under the topic directory.