Accreditation Association For Ambulatory Health Care Organizations

The Hospital Consumer Assessment of Healthcare Providers (HCAHPS) began in 2006 with a 27 question survey that is distributed to discharged patients. This survey process was originally designed to help patients compare hospitals in their area to be able to make an informed choice for their healthcare needs. In January 2013, five additional questions were added to the survey. Beginning this year, Medicare reimbursement rates to a hospital are tied to the hospital’s patient satisfaction scores. Therefore, hospitals are continually looking for ways to improve

Healthcare is in a constant state of change with movements that impact rates, access and quality of care. Hospitals have become more competitive due to the rising cost of care delivery and the reduction in reimbursement from payers. This causes difficulty in delivering quality care to all patients, which is being measured by mandated patient perception surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS scores are part of value

JCAHO (Joint Commission on Accreditation of Healthcare Organizations) Joint Commission Standards. 2000. Retrieved from www.jcaho.org/standard/jcstandards.html

The U.S. Office of Education recognized AMA/AAMA as an official accrediting agency for medical assisting programs in public and private institutions.

Since it’s founding in 1951, The Joint Commission has set standards and completed evaluations and accreditations for over 20,000 health facilities. Though not a government agency,The Joint Commission has a great level of authority in the field of healthcare and approval from the organization is often required by local health departments and CMS. Receiving the Commission’s seal of approval also goes a long way with potential clients familiar with the high standard of

The Accountable Care Organization (ACO) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients (McCarty, B., 2016). For example, Medicare Shared Savings Program was created by The Center for Medicare & Medicaid Services to monitor and establish that all ACO’s are meeting the quality performance benchmarks and reduce Medicare spending by certain percentages (H., 2017). The growth of ACO’s from 2011 to 2016 is astonishing, in 2011 there was 64 ACO’s and by 2016 they have risen to 838 in the U.S. (H., 2017).

This paper will discuss what the Accountable Care Organization is, why did Congress include it in their law, benefits and challenges for physicians and patients, and how does the ACO work for patients. We will also identify the quantitative methods in the ACO and reflect on the information provided.

In the past few years the American health care system has changed in many ways. First there was the passage of the Affordable Care Act, which is a law that is giving Americans the opportunity to obtain health care. Under this new law, in 2011, the Department of Health and Human Services decided to create Accountable Care Organizations (ACO) to help doctors, hospitals and other providers better coordinate care (AthenaHealth.com). The first idea of an Accountable Care Organization was brought up in 2006 by Elliot Fisher, MD, and now there are over 400 in the United States (Healthcatalyst.com). An ACO’s primary job is to improve health care delivery, performance, and payment. This is done through physicians and

The Joint Commission is a nonprofit organization that certifies more than 18,000 health care organization and programs throughout the world. Founded in 1951, the Joint Commission provides a national symbol of quality for health care as well as analyzes each organization’s commitment to meeting high quality performance standards. The Joint commission focuses on accrediting Acute Care Hospitals, ambulatory, behavior health, long term care, health care facilities, clinical laboratories, health care networks and hospice. Numerous of accreditation organization is also taking place within the United States, but the Joint commission remains the largest The Joint commission accredits 20,000 organization” which” one third are Hospitals.

​Kaiser Health News recently published an article on a new trend in healthcare. This trend introduces the Accountable Care Organization (ACO). The Centers for Medicare and Medicaid services defines it as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients” (“Accountable Care Organization,” 2015). According to the Affordable Care Act (ACA), the goal of the ACO is to be able to share health cost-savings with providers who are able to save money by eliminating unnecessary procedures and reduce health costs while increasing quality of care. ACOs make health professionals become more accountable in maintaining good-quality, coordinated healthcare for a patient through a value-based system that is evaluated through a number of criteria and benchmarks (Ronai, 2011).

The Affordable Care Act (ACA) legislated in 2010, has changed the United States health care industry. In addition to universal healthcare, one of the principles of the ACA is the ideal of accountable care. Specifically, adopting an Accountable Care organization (ACO) for Medicare beneficiaries under the fee for service program. An ACO seeks to hold providers and health organizations accountable for not only the quality of health care they provide to a population, but also keeping the cost of care down (1). This is accomplished by offering financial incentives to the healthcare providers that cooperate in, circumventing avoidable tests and procedures. The ACO model, seeks to remove present obstacles to refining the value of care, including a payment system that rewards the volume and intensity of provided services instead of quality and cost performance and commonly held assumptions that more medical care is equivalent to higher quality care (2) .A successful ACO model, will have developed quality clinical work and continual improvement while effectively managing costs, however this is contingent upon its ability to encourage hospitals, physicians, post-acute care facilities, and other providers involved to form connections that aid in coordination of care delivery throughout different settings and groups, and evaluate data on costs and outcomes(3). This establishes the ACO will need to have organizational aptitude to institute an administrative body to manage patient care,

The Joint Commission is an independent not for profit group that provides as the accreditation issuer within the United States. “…The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States” (Commission, 2017). Its purpose is to develop performance standards for accreditation programs that hospitals and other healthcare related organizations are required to pass to receive accreditation from the Joint Commission. These specifications are affirmed upon addressing vital elements of the daily operation that involve patient care, medication safety, infection control, and patient's rights. The importance

The American health care system has been victim to an escalation in the prices of health care services juxtaposed with inefficiency in delivery of care services. There has even been cases where State spending on the actual health care increased dramatically in the United States and one of the key components of curbing this problem which has been prevalent over the mass media and has been a major discussion among physicians is the advent of Accountable Care Organizations. Accountable Care Organizations (ACOs) is structured with the goal of trying to improve health care delivery and aid in the reduction of the overall cost of services (Weissert & Weissert, 2012). If there is insufficient coordination of high quality care delivery in the health care industry, this will have a negative impact on patient safety and diminish affordable care for patients. Hence, the development of ACOs is envisioned to be the savior of medical practices and can improve the overall fabric of the American society (Bresnick, 2013). ACOs serves as one of the answers for curbing the problem of high costs, low quality care and possible segmented delivery and as much as it serve as the major determinant for improvement in patient satisfaction, there are minor

The main mission of this association is to contribute to medicine as well as promote it to ensure the health of each and every citizen.This association is constantly working to create a healthier future for each individual and struggling to put aside the stereotypes of ethics and race in the health care environment.Moreover, they devotetheir time to the improvement of the public health, as well as increase the interest of doctors for their patients. American Medical Association expands the legislation so that it favors in large part to the doctors and patients. They try to find ways to increase the money spent for the medical education of the students.Here are some of the important points that this association has established and contribute:

The American Hospital Association (AHA) is a widely recognized health care advocacy organization that offers resources for health care professionals, public awareness campaigns and special certification programs. Passing an AHA exam means that the health care professional has a broad skill and knowledge base. Every AHA certification program in developed through collaboration among industry recognized experts and the AHA-CC certification program committee. Together, they offer the CHESP certification for health care professionals who work in health care environmental services.