The entry of a second major accrediting agency into the healthcare-network business underscores the momentum behind coordination of care as a priority for healthcare organizations.
The Joint Commission on Accreditation of Healthcare Organizations plans to start healthcare-network evaluations this spring using a new accreditation manual it approved this month (Jan. 24, p. 6).
The National Committee for Quality Assurance has accredited managed-care organizations since 1990. But it's poised to branch out into new types of network-style health plans as they take shape, said Janet Corrigan, the NCQA's vice president for planning and development.
The NCQA said it has reviewed about a third of the nation's estimated 550 managed-care organizations, and it's developing performance standards to go with existing accreditation standards in evaluating and comparing health plans.
Central to the initiatives of both agencies is the requirement that the activities of all facilities and services be coordinated at the network level.
The NCQA, for example, requires organizations to show they have a well-developed quality-improvement program with active measurement, assessment and follow-through networkwide. It's not enough for such plans to be in place only at individual institutions, said Ms. Corrigan.
The Joint Commission's standards include a chapter on continuum of care that evaluates, for example, whether a patient's entry into the network is based on his healthcare needs as identified by an assessment. Patients also must have a way of being informed about follow-up treatment, and the network must show that caregivers are passing along necessary information to whoever cares for the patient next.
Other chapters evaluate how networks fare in the areas of patient rights, organization ethics, education and communication, leadership, information management, human resources management and performance improvement.
Those areas mirror the "functional" categories into which the JCAHO is reorganizing its provider-specific manuals starting this year as part of its Agenda for Change, said William Jessee, M.D., vice president for research and standards.
The Joint Commission will train surveyors for the new initiative in April, and surveys will begin later in the spring, Dr. Jessee said.
Charges for network surveys haven't been determined, but it probably will be based on enrollment plus a factor of the time needed to cover a number of sites, he said.