Ac­cred­i­tors skep­ti­cal of plan to re­lease health­care provider au­dits to pub­lic

Modern Healthcare - - NEWS - By Maria Castel­lucci

Con­sumers may soon have ac­cess to a new pool of data when shop­ping for a health­care provider. The CMS is in the fi­nal stages of col­lect­ing com­ments on a pro­posed rule that would re­quire ac­cred­i­ta­tion or­ga­ni­za­tions to pub­licly re­lease re­ports on health­care fa­cil­i­ties they au­dit.

The pro­posal has come un­der heavy scru­tiny and op­po­si­tion from pri­vate ac­cred­i­ta­tion or­ga­ni­za­tions such as the Joint Com­mis­sion and from provider groups, who al­lege that the in­for­ma­tion will do more to con­fuse con­sumers than help them make smart de­ci­sions.

“When we do a sur­vey of a fa­cil­ity, it fo­cuses on de­fi­cien­cies that are found at a fixed point in time,” said Barb Sylvester, di­rec­tor of reg­u­la­tory af­fairs and qual­ity at the Ac­cred­i­ta­tion Com­mis­sion for Health Care, a not-for-profit that ac­cred­its about 15,700 providers, mostly in the hospice and home health are­nas.

The ACHC ac­cred­its fa­cil­i­ties once ev­ery three years and is on the look­out only for ar­eas where the provider has failed to fol­low reg­u­la­tory stan­dards of care. The ACHC then works with the providers to help them out­line and ap­prove a cor­rec­tive ac­tion plan.

The re­ports would only show con­sumers an or­ga­ni­za­tion’s weak­nesses, Sylvester said. They don’t em­pha­size pa­tient out­comes, which are more help­ful met­rics for those shop­ping for the best providers, she added.

“We are con­cerned that shar­ing a de­tailed re­port may not be the most use­ful or ef­fec­tive strat­egy for in­form­ing the pub­lic,” Nancy Foster, vice pres­i­dent of qual­ity and pa­tient safety at the Amer­i­can Hos­pi­tal As­so­ci­a­tion, said in a state­ment. Foster sug­gested it might be more use­ful to re-

“We are con­cerned that shar­ing a de­tailed re­port may not be the most use­ful or ef­fec­tive strat­egy for in­form­ing the pub­lic.” Nancy Foster Vice pres­i­dent of qual­ity and pa­tient safety Amer­i­can Hos­pi­tal As­so­ci­a­tion

quire ac­cred­i­tors to pro­vide a sum­mary of the re­ports with key take­aways.

Ex­perts fa­vor­ing the rule re­ject claims that the data won’t help con­sumers.

“The au­dits be­ing done by these agen­cies are not re­veal­ing the level of prob­lems that seem to ex­ist,” said Michael Abrams, co-founder of Numerof & As­so­ciates, a health­care con­sult­ing firm.

He points to the roughly 700,000 peo­ple who de­velop an in­fec­tion at U.S. hos­pi­tals and the es­ti­mated 250,000 peo­ple who die each year due to med­i­cal er­rors.

The CMS and oth­ers have ques­tioned how ef­fec­tive ac­cred­i­ta­tion or­ga­ni­za­tions are at find­ing prob­lems. A 2014 re­port on 103 acute­care hos­pi­tals by state of­fi­cials found ac­cred­i­tors missed 39 se­ri­ous de­fi­cien­cies af­ter their re­views. These gaps “raise se­ri­ous con­cerns” about pri­vate ac­cred­i­tors’ abil­ity to “ap­pro­pri­ately iden­tify and cite health and safety de­fi­cien­cies dur­ing the sur­vey process,” the CMS noted in the pro­posed rule.

In its com­ment let­ter, the Joint Com­mis­sion, which ac­cred­its nearly 21,000 health­care or­ga­ni­za­tions across the coun­try, ar­gued that the rule would ac­tu­ally harm trans­parency, sug­gest­ing that clients are more com­fort­able shar­ing con­cerns and is­sues be­cause they know the re­ports are con­fi­den­tial .

The rule would “make providers less can­did about their weak­nesses on our sur­veys, (and) it would chill the open and con­fi­den­tial di­a­logue that is the foun­da­tion of our im­prove­ment ef­forts,” the Joint Com­mis­sion said.

Both the Joint Com­mis­sion and the ACHC are also con­cerned the rule would be ex­pen­sive and dis­rup­tive. Say­ing it would have to de­ploy new soft­ware and hire ad­di­tional staff, the Joint Com­mis­sion pre­dicted startup ex­penses for the rule would cost it $3.97 mil­lion in the first year and $2.3 mil­lion for sub­se­quent years.

Since the CMS au­dits only 10% of providers, pri­vate ac­cred­i­ta­tion or­ga­ni­za­tions carry the lion’s share of the load.

Yet the re­la­tion­ship be­tween pri­vate ac­cred­i­tors and providers has an “in­her­ent po­ten­tial for con­flict of in­ter­est,” said François de Brantes, di­rec­tor of the Cen­ter for Pay­ment In­no­va­tion at the Al­tarum In­sti­tute. Providers pay a fee for ac­cred­i­tors’ ser­vices.

Re­leas­ing the re­ports pub­licly would em­power providers to main­tain qual­ity stan­dards and im­prove care, de Brantes said. It also would en­able providers who per­form well to tout their achieve­ments to con­sumers, fos­ter­ing com­pe­ti­tion.

Con­cerns about ad­min­is­tra­tive bur­den and cost aren’t an ex­cuse to re­ject the rule, de Brantes said. “Pa­tients won’t stop com­ing. But what might hap­pen is that things im­prove.”

Abrams said it’s im­por­tant for ac­cred­i­tors to in­vest in ways to make the re­ports easy to un­der­stand. If that means they have to charge providers more for ser­vices to swal­low the cost, so be it, he said. “They can charge hos­pi­tals just a lit­tle bit more.”

The pro­posed rule re­flects a grow­ing push from con­sumers for more in­for­ma­tion about where they re­ceive care, Abrams said. “Con­sumers are be­gin­ning to see health­care like the other things they pur­chase,” he said.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.