Government Continues Scrutiny Of Hospital Accrediting Bodies

The government continues to question the neutrality of The Joint Commission (TJC) and other healthcare accreditation firms that also have consulting arms. In a recent speech Seema Verma, the head of the Centers for Medicare & Medicaid Services (CMS), said her organization is continuing to evaluate options to increase oversight of accrediting firms.

CMS has spent over a year taking a closer look at some accreditation firms like the TJC that are being paid to accredit hospitals once every 3 years. These accrediting organizations are simultaneously paid through their consulting arms by those same hospitals to help them pass the accreditation process. The matter of passing an accreditation is an important one, as it determines a hospital’s eligibility to be reimbursed by Medicare and Medicaid, a huge contributor to their bottom-line. As this article by John Commins at HealthLeaders Media notes:

“Verma said that CMS in recent years has found inconsistencies in the way accrediting organizations inspect providers.

“Some even use standards that differ from our own, which is simply not acceptable,” she said.

CMS in December 2018 put out a request for information from accrediting organizations that Verma says was designed to “ascertain the scope of the issue.”

On Tuesday, Verma did not name specific accrediting organizations in her critique, but she called “a spate of serious deficiencies” that included patient harm and deaths at hospitals that had been deemed Medicare compliant “deeply concerning.”

“Receiving CMS’s authorization to inspect and deem healthcare providers compliant with Medicare’s quality standards is nothing short of assuming a sacred public trust responsibility,” she said. “But an increasing amount of evidence indicates that accrediting organizations are not living up to that high bar.”

“Our concerns are not only heightened by the growing trend of accrediting organizations providing fee-based consulting services to the same organizations they accredit; a glaring conflict of interest,” Verma said, adding that CMS does not allow “these kinds of relationships” in other areas, such as Quality Improvement Organizations in Medicare or external reviews in Medicaid.

The Joint Commission, the nation’s largest hospital accrediting organization, has denied any conflict of interest, citing a “long-standing firewall” it has created between its accrediting division and its consulting division, Joint Commission Resources, Inc.”

Read the entire article here: Verma Raps Accrediting Organizations’ ‘Glaring Conflict of Interest’

One possible result of this probe may be that hospital inspection reports will be made public in order to give additional information to consumers regarding their choice of healthcare providers. Is your hospital ready for your inspection reports to be made public? To prepare, hospitals have to make sure that they are following all of their detailed processes all of the time. Any breakdown in your processes would be made public via an inspection report, putting your hospital’s reputation and finances at risk. Consider automation tools that help track the processes that The Joint Commission and other accreditation agencies focus on during their inspections. Systems such as iRIScope and iRISecure have been developed to ensure that processes and protocols are being followed since your managers can’t watch over every step of the way.

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