Something's fuzzy about the communication lines among the Joint Commission on Accreditation of Healthcare Organizations, the American Hospital Association and the American Medical Association. The AHA and AMA control 14 of the 28 seats on the JCAHO's board of commissioners, but when the JCAHO announces a new initiative it's like a bomb went off in the executive offices of each organization.
Let's examine the JCAHO's controversial public disclosure plans and its proposed star rating system.
In May 1993, the JCAHO's board approved a plan to begin releasing facility-specific accreditation data to the public. The policy applies to traditional accreditation data as well as clinical outcomes data the JCAHO wants to start collecting from providers. The public release was supposed to begin as early as July 1994.
But this June, the AMA's House of Delegates passed a resolution instructing the association's staff and representatives on the JCAHO board to oppose the data release policy until the AMA has more time to study the issue. Huh?
Even more puzzling is the AHA's reaction to the star rating system a JCAHO task force approved in July. To simplify complex accreditation information for public consumption, the JCAHO proposed to award stars to hospitals based on their level of compliance with accreditation standards. The release also would include a detailed explanation of how hospitals gain and lose stars. JCAHO staffers arrived at the star system after months of testing various data disclosure formats in focus groups composed of physician, hospital and consumer representatives. The JCAHO board was supposed to approve the system this month, and the first release of data was supposed to occur as early as October.
MODERN HEALTHCARE broke the story about the star system, which subsequently elicited boos and hisses from the AHA's senior management. They now want the JCAHO to test run various disclosure formats in select markets. What?
Now we hear that the AHA and AMA are planning an October summit on quality data and public accountability issues. Good.
Here are some possible explanations for the confusion.
JCAHO senior executives aren't telling their board the full story, which isn't getting passed along to the AHA and AMA.
JCAHO senior executives are telling their board the full story, but AHA and AMA representatives on the board aren't hearing the same message.
JCAHO senior executives are telling the board the full story, the AHA and AMA representatives are listening, but they're not telling AHA and AMA senior executives.
All three parties know what's going on, but they're not telling their constituencies. Then, when hospitals and physicians hear about it, they complain to their respective trade groups. AHA and AMA executives then act surprised, and the JCAHO gets criticized once again.
If we were dues-paying or accreditation-fee-paying providers, we'd expect a little more clarity and straight talk.