Hello Jimmie: the first name is welch origin but I am Irish. I agree with your perspective on this. I just spent almost a year completing and submitting NCQA PCMH. I have no idea what level I will achieve nor do I care at this time. It was a total waste of my time. I doubt seriously if any of this truly impacts patients health better than the timed honored patient-physician relationship. If you care and put the time in you will get results that you want for your patients. I guess my thinking on the MU thing is commercial insurance is going to tie into this concept and pay for performance will be the norm. Any thoughts? Gwendolyn O'Guin. Family doc Maine.