Review other posts submitted by your classmates. In your responses, respectfully disagree with the conclusions drawn by the original posters. What factors did you weigh differently than the original poster and why? What strikes you as particularly persuasive regarding when governments should retain or outsource accreditation? Response post #1 Savannah Ventura  Accreditation is a comprehensive evaluation process in which a health care organization’s systems, processes, and performance are examined by an impartial, external organization to ensure that it is conducting business in a manner that meets predetermined criteria and is consistent with national standards (Teitelbaum & Wilensky, 2017). The various organizations in the United States that perform accreditation establish standards for healthcare delivery. These agencies, such as the Public Health Accreditation Board (PHAD), The Joint Commission, and the Agency for Healthcare Research and Quality (AHRQ), to name a few, play essential roles in ensuring the quality of healthcare. Accreditation programs with meaningful quality measures help foster continuous quality improvement by health plans and are a necessary complement to rigorous state and federal regulation of health plans (Wickersham & Basey, 2016). Accreditation bodies or entities evaluate and rate a wide variety of health care organizations, including care management companies, health insurance plans, pharmacy benefit managers, utilization review organizations, wellness organizations, and other health vendors, both in the commercial sphere and through government programs such as Medicare and Medicaid (Dunlap et al., 2016). Within the ACA, accreditation serves as a recognized component to states and state legislators to implement health reform and address health care issues. Many state laws already include accreditation standards for health care management, health care operations, and health information technology and pharmacy quality management activities as a quality assurance tool (Bauchner, Fontanarosa, & Thompson, 2015). Later, for hospitals and other health care institutions, the federal government and states used private accreditation as evidence of compliance with Medicare conditions of participation and state licensure laws, respectively. In so doing, the government effectively delegated regulatory responsibility for assuring that health care institutions meet the requisite quality standards for participation in their respective programs. When government relies on private accreditors to perform this vital function, questions arise about whether all the legitimate interests of the public served by public health insurance programs are adequately protected and promoted (Bauchner et al., 2015).  By outsourcing, hospitals and health systems can alleviate the numerous, complex responsibilities of an understaffed, unqualified internal department. Instead, they can entrust the credentialing and privileging tasks to a qualified .

1. Review other posts submitted by your classmates. In your
responses, respectfully disagree with the conclusions drawn by
the original posters. What factors did you weigh differently than
the original poster and why? What strikes you as particularly
persuasive regarding when governments should retain or
outsource accreditation?
Response post #1
Savannah Ventura
Accreditation is a comprehensive evaluation process in which a
health care organization’s systems, processes, and performance
are examined by an impartial, external organization to ensure
that it is conducting business in a manner that meets
predetermined criteria and is consistent with national standards
(Teitelbaum & Wilensky, 2017). The various organizations in
the United States that perform accreditation establish standards
for healthcare delivery. These agencies, such as the Public
Health Accreditation Board (PHAD), The Joint Commission,
and the Agency for Healthcare Research and Quality (AHRQ),
to name a few, play essential roles in ensuring the quality of
healthcare. Accreditation programs with meaningful quality
measures help foster continuous quality improvement by health
plans and are a necessary complement to rigorous state and
federal regulation of health plans (Wickersham & Basey, 2016).
Accreditation bodies or entities evaluate and rate a wide variety
of health care organizations, including care management
companies, health insurance plans, pharmacy benefit managers,
utilization review organizations, wellness organizations, and
other health vendors, both in the commercial sphere and through
government programs such as Medicare and Medicaid (Dunlap
et al., 2016). Within the ACA, accreditation serves as a
recognized component to states and state legislators to

2. implement health reform and address health care issues. Many
state laws already include accreditation standards for health
care management, health care operations, and health
information technology and pharmacy quality management
activities as a quality assurance tool (Bauchner, Fontanarosa, &
Thompson, 2015).
Later, for hospitals and other health care institutions, the
federal government and states used private accreditation as
evidence of compliance with Medicare conditions of
participation and state licensure laws, respectively. In so doing,
the government effectively delegated regulatory responsibility
for assuring that health care institutions meet the requisite
quality standards for participation in their respective programs.
When government relies on private accreditors to perform this
vital function, questions arise about whether all the legitimate
interests of the public served by public health insurance
programs are adequately protected and promoted (Bauchner et
al., 2015).
By outsourcing, hospitals and health systems can alleviate the
numerous, complex responsibilities of an understaffed,
unqualified internal department. Instead, they can entrust the
credentialing and privileging tasks to a qualified partner that
uses improved and integrated processes and industry-leading
best practices. Additionally, outsourcing can be an effective
strategy for hospitals and health systems seeking to control
spending while preparing for significant changes in their
practitioner relationships (Jaafaripooyan, Agrizzi, & Akbari-
Haghighi, 2011).
Types of factors that policymakers should consider when
discussing whether to outsource accreditation to private
accrediting bodies include the comprehensive and
multidisciplinary nature of the assessment, the fit of the
assessment method to the unique features of healthcare, the

3. inclusion of improvement as a goal of the evaluation, and the
use of highly trained surveyors with experience in healthcare
(Bauchner et al., 2015). Outsourced accreditation could be
evaluated in the following ways by assessing the impact of
accreditation on the quality and safety of healthcare delivery,
assessing the efficiency of accreditation tools and systems for
providing feedback with reliable information both to the
accreditation organizations as well as all key stakeholders, and
by evaluating the impact on the capacity development of
systems (Dunlap et al., 2016).
Accreditation has undeniably been an effective mechanism for
protecting society to safeguard public access to quality and safe
healthcare. Different stakeholders may rely on accreditation
results in their decision-making. A growing number of state-run
accreditation programs could allude to the increased reliance of
governments on accreditation results to safeguard the public
access to quality healthcare (Jaafaripooyan et al., 2011).
References
Bauchner, H., Fontanarosa, P. B., & Thompson, A. E. (2015).
Professionalism, governance, and self-regulation of medicine.
JAMA, 313(18), 1831-1836. doi:10.1001/jama.2015.4569
Dunlap, N. E., Ballard, D. J., Cherry, R. A., Dunagan, W. C.,
Ferniany, W., Hamilton, A. C., ... & Sears, A. (2016).
Observations from the field: Reporting quality metrics in health
care. Retrieved from
https://nam.edu/wp-content/uploads/2016/07/Observations-
from-the-Field-Reporting-Quality-Metrics-in-Health-Care.pdf
Jaafaripooyan, E., Agrizzi, D., & Akbari-Haghighi, F. (2011).
Healthcare accreditation systems: further perspectives on
performance measures. International Journal for Quality in
Health Care, 23(6), 645–656. doi:

4. https://doi.org/10.1093/intqhc/mzr063
Teitelbaum, J. B., & Wilensky, S. E. (2017). Essentials of
health policy and law (3rd ed.). Burlington, MA: Jones &
Bartlett Learning
Wickersham, M. E., & Basey, S. (2016). Is accreditation
sufficient? A case study and argument for transparency when
government regulatory authority is delegated. Journal of Health
and Human Services Administration, 39(2), 245. Retrieved from
http://eds.a.ebscohost.com.ezproxy.snhu.edu/eds/pdfviewer/pdfv
iewer?vid=2&sid=004c1f57-51e7-4570-927e-
2e9395ef4ddb%40sessionmgr4008
Response post # 2
Rachel Watson
Accreditation is a process of review from outside sources for
organizations to demonstrate the ability to meet regulatory
requirements and standards set forth (ACHC, n.d.). For
example, one of the most well-known and sought after
accreditations is Joint Commission, who is a globally
recognized leader for healthcare accreditation performing
unbiased assessments of patient care, quality and safety based
on standards set by the Centers for Medicare and Medicaid
Services (CMS) (The Joint Commission, 2020). Other
accreditations include Agency for Healthcare Research and
Quality (AHRQ), National Committee for Quality Assurance
(NCQA), Nursing Care Center Accreditation (NCCA), and
Healthcare Facilities Accreditation Program (HFAP) as just a
few examples as there are a multitude of accreditation options
depending on the healthcare organization and specialties.
Accreditation essentially has two fundamental purposes: to
assure the quality of care provided and aid in improving the

5. organization. While accreditation is voluntary, this type of
achievement sets forth a perception that the organization strives
for greatness in safety and quality and can meet objectives for
high-performing health care organizations through evidence-
based criteria.
As a provision within the Affordable Care Act (ACA),
requirements were set forth indicating all health plans offered
through the insurance exchanges must be accredited with
respect to performance on clinical quality measures, patient
experience ratings, access to care, utilization, provider
credentialing and network adequacy (National Conference of
State Legislatures, 2017). Another provision added required the
Secretary of Health and Human Services to recognize
accrediting bodies as well as requiring all health plans to
provide external review processes ensuring accreditation and
compliance with standards in federal ACA and NAIC state
models (National Conference of State Legislatures, 2017).
Regardless of changes affected by the ACA, the government,
both state and federal will continue to supplement oversight
activities with data presented by private accredited reviews.
That being said, accreditation acts as a supplement to
government regulations and standards set by CMS, but also can
serve as a substitute for public regulation. Areas such as higher
education are accredited by private agencies as the government
does not regulate accreditation for these entities, rather sources
out to other appointed agents. On the contrary, Joint
Commission hospital accreditation acts as an alternative to state
certifications, using Medicare’s federal regulatory standards;
therefore, JCAHO accreditation replaces Medicare certification
as the facility is deemed to meet federal standards and eligible
to participate in Medicare (Institute of Medicine, 2001).
Policy makers should consider a variety of factors when
considering whether to outsource accreditation to private
entities. Accreditation is a process that identifies best practices

6. and promotes quality improvement strategies and evaluation of
standards should be routinely analyzed and improved to keep up
with current trends and best practices. In the commercial health
insurance market, accreditation is generally used to comply with
state requirements. In this case, policy makers should ensure
whoever is responsible for the accreditation process is focusing
resources on problematic areas, contributing unbiased
evaluations and providing reputable feedback on accreditation
processes and outcomes. Furthermore, when the government
relies on outsourced accreditation agents, the legitimate interest
of the public should be adequately protected and promoted with
nothing to gain pending the outcomes of the survey. In other
words, there should be no conflict of interest when deciding
whether to outsource or not and whoever is providing the
assessment should not have a conflict of interest with the
organization, thus aiding in determining whether the
accreditation can be observed from the government or another
outsourced agency. This decision will provide safety to patient
standards, hold the organization accountable for actions and
give the public peace of mind that the survey results remain
unskewed and unbiased.
Rachel
References
ACHC. (n.d.).
About accreditation
. ACHC.org.
https://www.achc.org/about-accreditation.html
Institute of Medicine. (2001).
Preserving public trust: Accreditation and human research
participant protection programs
. National Academies Press.
https://doi.org/10.17226/10085

7. The Joint Commission. (2020).
Why the Joint Commission
. Leading the Way to Zero | The Joint Commission.
https://www.jointcommission.org/accreditation-and-
certification/why-the-joint-commission/
National Conference of State Legislatures. (2017, January).
Accreditation to approve health plans and providers
. NCSL.org.
https://www.ncsl.org/research/health/accreditation-to-approve-
health-plans-and-provider.aspx