Healthcare Financial News

Beginning January 1, 2009, under new Joint Commission policy, laboratory accreditation decisions will no longer immediately affect hospital accreditation decisions. This policy establishes comparability in the way that a laboratory with an adverse accreditation decision rendered by The Joint Commission or one of its cooperative partners, the College of American Pathologists (CAP) or COLA, affects the hospital or other organization with which the laboratory is affiliated. Currently, a laboratory’s accreditation has a direct impact on the accreditation status of its affiliated organization.

Under the new policy, the accreditation of laboratories and hospitals accreditation will continue to be linked, due to the critical importance of laboratory services to the delivery of hospital care. An adverse laboratory accreditation decision--whether due to a survey by the Joint Commission, CAP, or COLA--will help prioritize the hospital’s or other organization’s next unannounced survey.

“The new approach meets the needs of Joint Commission customers and reinforces the importance of the laboratory in the delivery of patient care,” says Ann Scott Blouin, Ph.D., R.N., executive vice president, Accreditation and Certification Operations, the Joint Commission.

Leaders in health care and healthcare policy feel strongly that the way we pay for health care in the U.S. must be fundamentally reformed. The latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey reports that more than two-thirds (69%) of respondents expressed strong dissatisfaction with the current system, which is generally based on “fee-for-service” payment, saying the current system is not effective in encouraging high quality and efficient care.

The current fee-for-service system reimburses individual services--hospital stays, physician visits, and procedures--rather than paying for the most appropriate care for the patient over the course of an illness or a time period. In doing so, it creates incentives to provide more technical and more expensive services, rather than encouraging more effective, higher-value care. Only one percent of healthcare leaders surveyed said they preferred the current fee-for-service payment system to alternative approaches.

There was strong support for a move away from fee-for-service payment toward bundled approaches, which make a single payment for all services provided to a patient during the course of an episode or time period. When asked about preferred options for payment reform, 53 percent of opinion leaders chose a blend of modified fee-for-service and bundled per-patient payment, while another 23 percent chose bundled per-patient payment alone.