Accreditation: Filling Regulatory Gaps in Quality-Based Healthcare

After launching more than 20 accreditation programs in healthcare since 1996, I have come to appreciate the important role accreditation standards play in filling regulatory gaps in the promotion of quality-based care.

The reality is the U.S. healthcare system is much more complex than it was in the 1970s or 1980s.  Thus, the effectiveness of regulations governing health insurance or related offerings today is inherently limited due to a number of factors such as:  1) limited government resources to enforce regulations; 2) the number of different regulatory agencies that oversee different health insurance arrangements; 3) the challenge of keeping regulations up-to-date in an ever-changing landscape; and 4) the increasing sophistication of insurance solutions in today’s technology-driven marketplace – among other factors.

This is where the value of accreditation can be demonstrated. For example, CHQI’s Telemedicine Accreditation Program Standards and Guide covers a broad array of requirements and performance criteria that are not covered in existing regulations.  In cases like this, the accreditation process provides a comprehensive framework to assess how telemedicine organizations are functioning. The process also provides feedback to applicants so they may enhance their policies, procedures, and services, taking the important steps necessary to promote access to safe, quality, and competent health care.  In turn, third parties can rely on CHQI’s good housekeeping seal of approval.

So how are accreditation standards leveraged beyond the application process? CHQI launched its new Telemedicine Accreditation Program in March 2018.  The program Standards already are being leveraged as part of Request For Proposals (RFPs), including the National Alliance for Healthcare Purchaser Coalition’s eValue8 criteria.  Historically, government agencies have recognized accreditation standards to promote standardization as part of the licensing process.  We are confident that state and federal agencies will soon look to CHQI’s Telemedicine Standards to guide their future regulations and sub-regulatory guidance as well.

Reducing the fragmentation and segmentation of healthcare remains an important goal for all of us who aim to promote quality, continuity and best practices.  CHQI is in the process of developing and launching a number of accreditation programs, in addition to our Telemedicine Accreditation Program, that help promote these goals.  Stay tuned for more updates in the near future!

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