The Joint Commission on Accreditation of Healthcare Organizations said last week that it will temporarily lift requirements of its beleaguered Oryx initiative for organizations pursuing accreditation for the first time.
New accreditation seekers will still have to identify and track two new clinical measures per year, but they won't have to buy a JCAHO-approved performance measurement system for two years or until the JCAHO establishes provider group-specific "core measures." They also won't be required to report the data they are collecting to the JCAHO during this time.
The JCAHO's board of commissioners made the change, in part, in an effort to combat a recent decline in the number of organizations seeking accreditation and a corresponding drop in revenue (Sept. 24, p. 7).
The JCAHO said the intent of the action is not to bolster its bottom line.
"We really don't know what impact this will have on our revenues," said spokeswoman Charlene Hill.
Hill said the board reviewed the results of a field survey on provider concerns and made its decision in response to those findings.
"The idea is to get people on the train, and once they are on . . . you can move that train out of the station," said Jerod Loeb, JCAHO vice president of research and performance measurements.
Last year, the JCAHO revamped Oryx in response to hospital industry pressure. After a complaint from the American Hospital Association and 17 state hospital associations, the JCAHO agreed to cap at six the total number of quality measures that providers would be required to track. The JCAHO also eliminated a rule that initial measures would need to represent at least 20% of the hospital's patient population.
Loeb said the issue of cost impact on those seeking accreditation was important in the board's decision to suspend the requirement to buy a performance measurement system.
The bulk of the JCAHO's potential market for new accreditation customers consists of long-term-care facilities, home healthcare organizations and behavioral healthcare providers, many of which have been hit the hardest by Medicare and Medicaid payment limitations imposed by the Balanced Budget Act of 1997.
The annual cost to contract with one of the 218 JCAHO-approved performance measurement systems is about $10,000 and the commitment of one full-time employee, Loeb said.
The JCAHO is firm that while the requirement to buy a measurement system has been temporarily lifted for first-time accreditation seekers, the expectation to comply with other aspects of Oryx remains.
The JCAHO began implementing the Oryx requirements for accreditation-seeking hospitals and other types of healthcare organizations in 1998. Providers are to select and track two quality measures of their own choosing each year. By 2002, the JCAHO anticipates it will require organizations to monitor a standardized set of core measures.