Accreditation In Healthcare

The passage of the ACA has changed and still changing the quality of services delivered to four major stakeholders: patients, employers, healthcare providers and states. As the result of the ACA, the congress established the Center for Medical & Medicaid Innovation (called now Innovation Center) and mandate “both robust financial support and unprecedented degree of flexibility in testing and evaluating care delivery and payment/reimbursement models” (p.459). The purpose of the Innovation Center is to “identify, test and spread delivery and payment models to help providers improve care while cutting costs”(p.459).
One of the ACA focus was on Value-Based Purchasing because of the high cost in healthcare. The aim is to delivery high quality
with a lowest cost and measurement tools were placed in place to measure the improvement. In minority area, the healthcare organization gets a reimbursement based on the improvement without being compare to others. The reason is to encourage the healthcare provider to continue providing care and not to avoid patients who could affects the outcome scores.
The federal government would reimburse healthcare organizations when they adopt the use of the use of EHRs meaningful due the benefit to collect, report, and use data for quality improvement.
The ACA in combination with other acts “have made a significant contribution to improving several important aspects of quality, including value-based purchasing, electronic health records(EHRs), consumer information, and the establishment of a national healthcare quality strategy”(p.466).

One way to achieve accountability and quality improvement is thru accreditation.
“Accreditation can be defined as a process in which an entity external to the organization providing goods or services evaluates that organization against a set of predetermined requirements or desirable attributes and publicly attests to the results” (p.495); however, licensure involves individual professional. Organization accreditation in the USA is done by the private sector bodies and it is voluntary. On the contrary, licensure is mandate and it is provided and regulated by the government. Licensure is another way to achieve accountability and quality improvement. Individual who seeks to be licensure has to show competence in their field, keep current with continuous education and quality improvement would be on their list in the effort to avoid malpractice litigation and their licensure from being revoked. Regulatory forces want “professional group to offer accreditation” (p.496) so it would be a double reinforcement with licensure, which would increase accountability and quality improvement as individual professional as well as organizational. Accreditation and licensure goes hand on hand “Accreditation exists where both a professional drive to set and maintain standards and either regulatory or market pressures that support accreditation as an alternative to regulatory oversight by the state or federal agencies are
present”(496).