Ethan Rhodes
There are many hospital accreditation agencies around the world, each with its own unique mission, activities, board compositions, and organisational histories. The largest and most widely used accreditation organisation in the US is the Joint Commission on Accreditation of Healthcare Organisations (JCAHO). The International Society for Quality in Healthcare (ISQua) is the umbrella organisation responsible for accrediting the Joint Commission, as well as accreditation organisations in the United Kingdom, Australia, and Canada.
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What You'll Learn
The Joint Commission
One key component of The Joint Commission's accreditation process is the unannounced full survey, which was implemented in 2006. These surveys occur 18 to 39 months after the previous unannounced survey, and the organization does not receive advance notice of the date. The purpose of unannounced surveys is to ensure a true evaluation of the organization's performance and to address any serious problems in the delivery of care.
In addition to its work in the United States, The Joint Commission also has an international presence. Joint Commission International (JCI), established in 1998, extends the organization's mission worldwide. JCI works with international healthcare organizations, public health agencies, and health ministries to improve the quality of patient care and enhance patient safety in more than 60 countries.
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National Committee for Quality Assurance (NCQA)
The National Committee for Quality Assurance (NCQA) is a national leader in the development of accreditation programs and quality measures. It is one of the many organizations in the United States that perform accreditation and establish standards for healthcare delivery. The NCQA provides an evidence-based program for case management accreditation available for use in payer, provider, and community-based organizations.
State and federal regulators recognize NCQA's programs as setting the standard for high-quality health care in Medicaid, Medicare, and commercial plans. The NCQA's programs directly support health care organizations in meeting state and federal regulatory requirements. They leverage their decades of experience recognizing effective care delivery models to influence and support current and future designs for high-quality behavioral health care. The NCQA is, therefore, uniquely positioned to support crucial improvements in behavioral health care, from research and framework development to their new Certified Community Behavioral Health Clinics (CCBHC) program.
Health plans seek accreditation and measure performance through the administration and submission of the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The NCQA's Virtual Care Accreditation helps organizations build trust and improve care quality.
The NCQA was founded to answer the question of how healthcare can improve faster. The organization is based in Washington, DC, and its members are invited to learn more about the new CCBHC program.
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$19.95
American Medical Accreditation Program (AMAP)
The American Medical Accreditation Program (AMAP) is a voluntary, comprehensive accreditation program that measures and evaluates individual physicians against national standards. The program was designed by the Chicago-based American Medical Association (AMA) and piloted in New Jersey.
AMAP offers accreditation to individual physicians based on 12 core standards in the areas of education, licensure, ethics, and practice operations, as well as 11 out of 22 other supplemental standards. The 12 core standards include requirements such as graduation from an accredited medical school, a current unrestricted medical license, and no disciplinary action against any medical license within the past five years.
The governing board of AMAP includes three members of the AMA board of trustees, representatives of county, state, and specialty societies, a hospital representative, and a managed care plan representative. There are also representatives from the Joint Commission on Health Care Accreditation and the National Committee for Quality Assurance, as well as a voluntary health organization, a consumer group, an employer, and four at-large members.
The cost of AMAP accreditation is $50 for AMA members and $150 for non-members. In addition to the accreditation fees, health plans and hospitals may also purchase AMAP information, such as credential verification and continuing education.
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International accreditation
The Joint Commission
The Joint Commission, previously known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), is one of the most widely recognized and utilized accreditation organizations globally. It operates not only in the United States but has also expanded its reach to other countries. For instance, Mexico signed an agreement with the Joint Commission in 2009 to adopt U.S. hospital standards for accreditation. The Joint Commission sets standards, conducts surveys, and provides accreditation to various healthcare organizations, playing a pivotal role in improving healthcare quality.
International Society for Quality in Healthcare (ISQua)
ISQua serves as an international umbrella organization that accredits other accreditation bodies. It is responsible for accrediting prominent organizations like the Joint Commission accreditation scheme in the United States, Accreditation Canada International, and accreditation bodies in the United Kingdom and Australia. By providing this overarching accreditation, ISQua ensures that the accredited organizations maintain exceptional standards and continuously strive for improvement.
Country-Specific Accreditation Organizations
Several countries have established their own healthcare accreditation agencies, each with its unique structure and focus. For example:
- Agency for Accreditation of Health Institutions of Serbia (AZUS)
- Taiwan Joint Commission on Hospital Accreditation
- Healthcare Accreditation Institute (Public Organisation) in Thailand
- Instance National d'Evaluation et de l'Accréditation en Sante (INEAS) in Turkey
- United Kingdom Accreditation Forum (UKAF)
These organizations tailor their accreditation processes and standards to meet the specific needs and healthcare landscapes of their respective countries. They work closely with healthcare providers and the government to ensure that hospitals and healthcare services adhere to established standards, ultimately enhancing the quality of care delivered to patients within their jurisdictions.
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Medicare and Medicaid
The Centers for Medicare & Medicaid Services (CMS) is an agency within the US Department of Health and Human Services. It is responsible for administering Medicare and overseeing state programmes like Medicaid and the Children's Health Insurance Program. To qualify for billing through Medicare and Medicaid, healthcare facilities must undergo the CMS accreditation process. CMS has approved several organisations to conduct accreditation surveys on its behalf, including the Healthcare Facilities Accreditation Program (HFAP) and the Center for Improvement in Healthcare Quality.
Accreditation by a CMS-approved national accreditation organisation exempts healthcare facilities from routine surveys by state-authorised agencies. This reduces the number of unannounced inspections and provides peace of mind to healthcare organisations. The accreditation process evaluates hospitals and medical practices against specific standards and requirements to ensure they provide safe and quality care to patients.
Healthcare Life Safety Services is one example of a company that provides support and guidance to healthcare facilities seeking CMS accreditation. They offer inspections and evaluations to help medical facilities prepare for the accreditation survey process and understand what corrections may be needed. This preparation is crucial for healthcare organisations to meet the necessary standards and obtain accreditation.
Several other accreditation organisations also have deeming power for Medicare and Medicaid, including the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) and the Accreditation Association for Ambulatory Health Care (AAAHC). These organisations play a vital role in ensuring that healthcare facilities meet the required standards and can provide services to patients covered by Medicare and Medicaid.
The interplay between accreditation agencies, healthcare facilities, and Medicare and Medicaid billing demonstrates the complex nature of healthcare administration. The ultimate goal is to ensure that patients receive quality care while healthcare providers can efficiently navigate the accreditation and reimbursement processes.
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Frequently asked questions
The Joint Commission (previously known as the Joint Commission on Accreditation of Healthcare Organizations) is one of the most widely used accreditation organizations in the US.
Other agencies include the National Committee for Quality Assurance (NCQA), the American Medical Accreditation Program (AMAP), the Accreditation Association for Ambulatory Health Care (AAAHC), and the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).
Accreditation agencies establish standards for healthcare delivery and work towards achieving higher-quality care.
Internationally, the International Society for Quality in Healthcare (ISQua) is an umbrella organization that accredits accreditation schemes in the US, the UK, Canada, and Australia.
