The main objective of establishing an accreditation organization, especially in health sectors, is to ensure that associated health care institutions are well set out based on the minimum stipulated standards. This ensures that these institutions actively engage public participation in the health care. In the process, these accredited institutions play an informative role that ensures that consumers are adequately acquitted with the administered healthcare services. This, in turn, enables them to make decisive choice that is less costly, but effective. In the US, Centers for Medicare and Medicaid Services (CMS) have played this functional role in ensuring that health care institutions adhere to the required settings. This paper evaluates the CMS standards (core measures) and compares them with the guidelines provided by the Joint Commission organization. It also describes the benefits and constraints associated with various health care quality and safety standards in promoting quality.
According to Daly (2010), the Centers for Medicare and Medicaid Services (CMS) were established to offer the minimum health and safety standards for providers and suppliers involved in Medicare and Medicaid programs. He notes that CMS is entitled in administering the quality compliance standards for patient care institutions such as hospitals, nursing homes and hospices among others. Additionally, these quality standards are administered by health care supplying agencies for diagnosis and therapy services. Therefore, for any institution to be certified for Medicare programs, it must as well meet the institutional standards for Medicaid programs as illustrated by CMS standards.
Analyzing CMS Standards (Core Measures) and Comparing them to the Joint Commission Proposed Standards
As pointed out by Dickens (2010), the CMS core measures are classified into four categories. This include: pneumonia, surgical care, acute myocardial infarction and congestive heart failure improvements. The CMS core measures utilize the results of evidence based medical practices by focusing on actual patients’ care in improving the quality of health standards. Most significantly, CMS has incorporated automated reporting solutions that ensure that hospitals quickly and effectively identify and resolve the root cause of the troubles they experience in the health care processes.
Menendez (2010) notes that the CMS core measures tend to curb the time lag of several months between when data is reported, processed and reported to the public, as evident in Joint Commission organization’s guidelines. For instance, the pneumonia project, which was then changed into Hospital Inpatient Quality Reporting Program (IQR), is intended to effectively equip patients or the general public with quality care information in order to make an appropriate decision on their health care options (File, 2011).
However, the Joint Commission guideline proposals to revise elements of performance (EPs) that provide direct diagnosis, therapeutic as well as emergency services for consumer participation tend to emulate CMS standards. According to the Joint Commission organization, such accreditation proposal is to ensure that they meet and maintain the Conditions of Participation based on CMS standards. This approach seems to be similar to the CMS’s IQR standard. According to Wonderly (2011), IQR requires hospitals to effectively submit data for specified health conditions. Such conditions are generally common to patients under Medicare programs. Failure to do so results into 2 percent reduction of annual funding from CMS. This is meant to strengthen the transparency of potential quality information to consumers in order to make quality health decisions that lower their healthcare costs.
Therefore, it is essential for health care organizations to adapt to the Joint Commission’s elements of participation (EPs) proposal in promoting the quality of health care. According to the Joint Commission (2009), engaging such proposals enables the health care organization to be able to meet Medicare and Medicaid certification requirements. For instance, the Joint Commission proposes that for it to deem the status of any hospital, it should be able to notify its recipients on the need to engage in testing and counseling programs as well as their prescribed restrictions. This would not then subject the health care organizations into routinely Medicare surveying and certification process thereby maintaining its deeming authority.
However, File (2011) notes that the limitation of engaging the core measures and the proposed health standards is that they offer variations between the recommended evidence-based optimal care services with the practice guidelines. Therefore, continuing education should be recommended to enable the health care professionals to follow the recommended guidelines to avoid breaching on the patients’ privacy and confidentiality. However, such measures can be better ensured through such aspects of health quality and safety as credentialing and accreditation which, except for the additional expenses, can together ensure the reduction of this variance.
In conclusion, it is essential for health organizations to adapt quality health settings that not only deem their status, but also enable them in offering quality healthcare services to consumers. Moreover, there is a need for healthcare organizations to emulate the Joint Commission’s elements of participation proposal that will ensure that the public is well informed on the quality healthcare services thereby making sound decision that adequately suits their need and budget.