Assignment Writing Help on Health Care Accreditation

Health Care Accreditation

            Today’s health care domain is characterized by a good number of issues that has caught the attention of both the media and health care consumers.  A few decades ago, health care arena was dubbed as a period of performance measurement. All the relevant stakeholders; provider, consumer or purchaser were all striving to find ways that could satisfy measuring and reporting healthcare outcomes. At this point in time, accountability was at stake, and several third-party organizations attempted to develop certain measures to cater for the health care outcomes (Tu and Laurer pg 34-36). Some countries like United States had a number of “indicators” that were created to develop and measure “report cards” all in an effort to measure performance. Unanimously, these countries and institutions agreed for there to be an organized mechanism to account for quality, continuous improvement and improved performance in health care. Consequently, for this to be achieved, certification, licensure or accreditation should be enacted (Siegel et al.   137-158). This paper therefore, addresses the concept of accreditation and health care accreditation programs related programs, critically analyzing each healthcare programs benefits and weaknesses and in return provide a rationale for the programs according to their quality.

Accreditation is the process of reviewing , those health care organizations participates in to demonstrate pre-determined criteria as well as compliance with the standards of accreditation as already established by professional accrediting agency (Shih et al. pg 45-57).

            The Accreditation Association for Ambulatory Health Care (AAAHC), established in 1979, is a non- profit accrediting body that develops standards to improve the quality of health care and develop ways to measure performance. AAAHC is recognized by various stakeholders in the health care accreditation value chain; among them third part entities like Medicare and Medicaid, health insurers, Medicare Advantage plans and so forth. AAAHC is certified ambulatory surgery centers for Medicare by CMS that has accreditated more than 5,100 organizations and proud to have been granted “deemed status “by CMS as it boasts to be granted. AAAHC is an organization of choice by many due to their emphasis on education and consultation to organizations, peer –based accreditation program, nationally- recognized standards and CHC-specific surveyors who  perform surveys are selected, trained , and privileged to conduct FQHC surveys (Siegel et al. pg 137-158).

            Home healthcare in United States has become increasing important, especially as a result of the growing elderly population contribution to the demand of long-term care services. The Community Health Accreditation Program (CHAP) was established in 1965, as an independent, non-profit accrediting body implemented to distinguish that a community or home health organization has voluntarily sustained optimal standards. CHAP was accredited by Center for Medicare and Medicaid Services  in 1999 and granted “deemed authority”. CHAP mandate is to provide home health and hospice services, as well as to determine compliance of Medicare Conditions of Participation in place of state surveys. The presence of a regulatory body motivates community and home health providers to achieve continuous improvement by adhering to certain standards. This in turn helps assist the public in the selection of community health services and providers by demonstrating their achievements. CHAP accreditation is available to organizations providing variousservices including home health, hospice, home medical equipment, homepharmacy, infusion therapy, nursing, private duty services, home care aideservices, public health, supplemental staffing services and communitynursing centers. The process of accreditation includes several steps namely; self-study, document review and content analysis, site visit, developing site review document which acts as the legal document, site visit report review by the board, corrective actions and recommendation amendment and finally accreditation decision is made either by accrediting the organization, denying or revoking the accreditation.TheCHAP Standards of Excellence provide guidance and criteria for theevaluation of an organization, which are based on four-key “UnderlyingPrinciples” namely; organization structure to consistently support its consumer –oriented goal, mission and purpose; provision of high-quality services by the organization; adequate resources (human and financial) provided to accomplish the stated mission and purpose; assurance that organization is well positioned for long-term viability (Tu and Laurer 34-36).

            The National Commission for Quality Assurance (NCQA)is an independent, not-for-profit organization whose purpose is to improve the quality of healthcare by providing accountability for healthcare organizations.  Accreditation process by NCQA involves both systems quality and health plans processes assessment.

The NCQA examines service plans and the care they deliver in areas such as preventive care.

NCQA accredits managed care organizations with a view to enhance patient’s ability to make informed decisions on which health plans to select.  NCQA accreditation program helps in generation of useful information about the quality of health care, giving the consumers a base to make informed decisions. This is in line with, NCQA mission to improve the quality of health care. Information generated by NCQA practitioners and other healthcare workers as feedback on various health plans, points out the gray areas that require urgent improvement.

Several health plan areas are assessed during the accreditation process, one of these is the presence of quality improvement in three domains; program structure and operations of the organization, availability of healthcare practitioners and services, and adherence to practice guidelines.  An organization completes an Interactive Survey System (ISS), before applying for accreditation with NCQA. ISS support electronic self-surveys that streamline the initial process and thus fast (Heinemann pg 654-837).

            AAAHC has a bunch of benefits for its esteemed customers that consists of; expediting third-party (insurance payments), providing a report card for the public, inclusion of the patients at the decision making level, provision of staff education tool, aids in professional staff recruitment,  the ability to find new ways to  improve the care and services they offer and  ability to develop alliances with other provider groups and health care organizations (Brown 45-57).

            CHAP benefits include;  collaboration with health insurance premiums, high level of patient involvement in all stages of decision making, highest quality management, well recruited and trained professions who join this organizations, access  to a set of highly qualified personnel as well as the stressed intra and inter organization collaboration. CHAP cost of accreditation is influenced by two factors namely; number of services to be accredited and how many locations the service is provided from.

Many organizations view CHAP as cost effective with invaluable investment infrastructure and has more room for performance improvement. CHAP offers an accreditation valid for three-year cycle, which is billed in four interest- free installments (Brown pg 45-57).

            Finally NCQA does not short-change its customers, and the following are the benefits receivable when you get accredited by NCQA; increased confidence on the part of persons seeking services for themselves or family members, involvement of the persons served as active participants in planning, selecting, evaluating, and improving the services provided, on-site education and consultation to help refocus business on the persons served and integrate business

functions with service delivery, an internal management tool promoting active, dynamic planning focused on positive outcomes for persons served and other stakeholders, the impact of strategies on these key groups, and organizational development of existing or new services to meet the needs and expectations of the community served and finally participation in insurance programs that offer discounted premiums to eligible providers (Brown pg 45-57).

The chart below displays the For example, the cost estimate for one location , single service either home  health or hospice, and a 3-year accreditation for a given organization with approximately 150 patients within 1 year is as shown for the three accredited related programs.

Organization Annual InstallmentThree Year Accreditation Fee (3 X Annual Fee)  Site Visit DaysSite Visit Fee* ($1145 per day inclusive)Total Estimated Cost
CHAP$1,527.00$4,581.003$3,435.00$8,016.00
NCQA AAAHC$1,341.00 $1,619.00$4,023.00 $4,857.003 3$3,925.00 $5,435.00$7,846.00 $9,565.00

            In conclusion, accreditation of organizations in health care is critically important to ensure improved performance and measure output. Some of the benefits of accrediting health care organizations; aiding and organizing patients safety efforts,   provides mechanisms for risk avoidance and reduction, provides staff training and capacity building, competitive edge in the market and reduced liability of insurance costs among others. The above 3 described health care accrediting organizations have been granted the “deemed status” by Centers for Medicare and Medicaid Services. Following careful discussion, description of the three named organizations, the writer has ranked them as follows; The Accreditation Association for Ambulatory Health Care (AAAHC), Community Health Accreditation Program (CHAP) and Community Health Accreditation Program (CHAP) respectively.

Work Cited

Brown JA. The Healthcare Quality Handbook: A Professional Resource and Study Guide. JB Solutions, Inc. Pasadena, California. 2009. 45-57. Print

Heinemann. EG. The Contemporary Use of Standards in Health Care. Division of Strengthening of Health Services: World Health Organization, 2010.

Shih A, et al. Organizing the U.S. Healthcare Delivery System for High Performance. The Commonwealth Fund.  New York: Pocket, 2008. 532-657. Print

Siegel JE, et al. Recommendations for reporting cost-effectiveness analyses. Journal of the American Medical Association.  London: Longman, 2007.137-158. Print.

Tu HT, Lauer JR (2009). Designing effective health care quality transparency initiatives. Issue Brief Center for Studying Health System Change. Washington, DC: Cato Institute, 2009.34-36 Print.