Promoting Quality-Based Public Policy Goals Through Accreditation

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During my career as an accreditation executive, I have had the privilege of helping develop and bring to market 23 different accreditation programs in healthcare for four different accreditation agencies.

I will never forget the first accreditation program that I worked on. In the mid-1990s, I helped finalize and implement a new accreditation program for preferred provider organizations (PPOs). The U.S. healthcare system had evolved from indemnity insurance to managed care plans, like health maintenance organizations (HMOs), to point-of-services plans like PPOs. Unlike indemnity insurance or HMOs, PPOs were only regulated superficially in a couple of states at that time. The new PPO accreditation standards really paved the way for the promotion of quality-based operations for these new insurance arrangements. Over time, regulations were adopted in most states and the federal government to help govern PPOs.

It was not easy going at first. The new PPO standards, also referred to as the health network accreditation program, had to be tweaked at the beginning. The first wave of PPO applicants had to be sent back to upgrade their credentialing procedures and make other enhancements to meet the accreditation requirements. The new PPO standards came to take on an important public policy leadership role by helping Americans sign up for these types of plans, which in turn allowed individuals to balance the benefits of managed care while retaining the choice to go out of network to see a provider—if there was too long of a wait or another issue with the plan’s network providers.

Over the years, I have been part of several interesting accreditation stories like this, where new accreditation programs assumed a leadership role or filled in key regulatory gaps to promote shared public policy objectives.

Of all of the standards that I have worked on, I think RadSite’s MIPPA Accreditation Program Standards stands out. In large part, this is due to the U.S. Centers for Medicare and Medicaid Services (CMS) requirement that MIPPA-accredited organizations combine traditional “process-based” standards with a “technical component” to help evaluate quality and performance.

As part of the technical component, a senior radiologist reviewer grades the “quality” of sample image case studies for each advanced diagnostic imaging (ADI) system going through the accreditation process. Likewise, a physicist reviewer grades key “performance” indicators of the same imaging system, along with the findings of the latest physics report.

In the U.S. today, many healthcare accreditation programs don’t include a technical evaluation. Under MIPPA, the technical assessment can shed important light on the diagnostic fidelity and accuracy of CT, MRI and Nuclear Med imaging systems that would not be picked up by traditional process-oriented standards.

Yet, there is still more that we can be doing in the future to promote the clinical efficacy of imaging systems. Stay tuned as RadSite releases the new version of its Standards (MIPPA Accreditation Program v 3.0) later this spring, where we have taken some of those steps.

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