- CMS wants to know more about the financial relationships between accrediting agencies and the healthcare facilities they're supposed to review and monitor. The agency is asking the public for comments through a request for information (RFI) released this week.
- In addition to accrediting facilities, some agencies provide consulting services for a fee to the same facilities they monitor. CMS is concerned this may create a conflict of interest and "erode the public's trust" in these accrediting agencies, Administrator Seema Verma said in a statement Tuesday.
- The issue was flagged after state-level audits of these facilities — in particular hospitals and psychiatric hospitals — caught serious issues that CMS alleges accrediting agencies missed. CMS will use the feedback it receives for potential future rulemaking.
This RFI is the latest effort from CMS to ramp up oversight of accrediting organizations (AOs).
In October, the agency said it would make the hospital accrediting process more transparent by posting performance data from the accrediting agencies online, including complaint surveys and the deficiencies found in facilities.
CMS also said it would insert itself into the process by directly observing accrediting agencies during its survey process. It said the latest move is another effort to ensure quality in healthcare facilities.
"Our data shows that state-level audits of healthcare facilities are uncovering serious issues that AOs have missed, leading to high 'disparity rates' between the two reviews," Verma said in the statement. "We are taking action across-the-board to ensure the quality and safety of patient care through strengthened CMS oversight of AOs, and today's RFI is a critical component of that effort."
To receive Medicare reimbursement for providing care, facilities must either be accredited or pass state inspections.
One of the largest accrediting organizations in the U.S. is the Joint Commission, which accredits and certifies nearly 21,000 facilities across the country. The Joint Commission also has a consulting arm, Center for Transforming Healthcare at the Joint Commission. The center describes itself as the nonprofit affiliate of the Joint Commission.
The increased oversight comes on the heels of a report in The Wall Street Journal that found mortality rates at hospitals inspected by the Joint Commission are no different than hospitals inspected by state agencies. The WSJ report relied on data from a Harvard study.