The volley of blunt words from the American Hospital Association slammed into the Joint Commission on Accreditation of Healthcare Organizations in mid-April, emptying two barrels of criticism:
* that the commission's fledgling foray into the business of contracting for Medicare peer-review work constituted "one more example of the JCAHO's seeming inability to decide whether it is an accrediting organization or a regulatory agency-one more arm of a government bureaucracy."
* that the commission faced "serious problems surrounding the accreditation process, the development of standards and other issues critical to that core mission" but seemed to be moving "at a glacial pace" to resolve them.
Last week the two feuding organizations said they had narrowed their differences after hashing them out, most notably in a 31/2-hour parley May 10 in Washington that included AHA President Richard Davidson, JCAHO President Dennis O'Leary and three officers of the JCAHO's 28-member governing board: Chairman John Noble, Vice Chairman Bernard Hengesbaugh and Fred Brown, who chairs the AHA's contingent of seven commissioners.
As a result of that face-to-face session, Davidson told Modern Healthcare reporter John Morrissey that the JCAHO was much further along in accreditation-improvement activities than it appeared to be, and O'Leary acknowledged that the Oakbrook Terrace, Ill.-based agency could do a better job of communicating its initiatives to the healthcare industry.
But the display of collegiality did not hide a continuing undercurrent of differences. O'Leary held fast to the JCAHO's being able to bid as a subcontractor to handle quality-evaluation aspects of a peer-review organization, something Davidson regards with suspicion. It was the JCAHO's decision to subcontract with CIMRO Quality Health Solutions, an Illinois medical-review group, for that state's PRO business that triggered the AHA's ire (April 22, p. 8).
The following edited excerpts from a question-and-answer session last week between Davidson and O'Leary, moderated by Modern Healthcare, provide details of these and other issues.