Healthcare Quality: Exploring Accreditation, Reimbursement, and Safety

This report examines the multifaceted influences on healthcare quality, focusing on three key areas: Joint Commission accreditation, CMS reimbursement requirements, and value-based purchasing (VBP). The Joint Commission, a non-profit organization, sets standards for healthcare organizations, impacting patient safety, medication safety, and overall quality through accreditation. CMS, responsible for government-funded medical coverage, implements quality initiatives and reimbursement models, aiming to ensure high-quality healthcare for beneficiaries, with an emphasis on goals such as effectiveness, efficiency, and patient-centered care. As healthcare costs rise, VBP, tied to compensation, incentivizes quality improvements and cost containment, influencing how providers are compensated and evaluated. The report uses literature to support the observations, providing a comprehensive overview of how these factors shape the healthcare landscape.

Running head: HEALTHCARE QUALITY
HEALTHCARE QUALITY
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1) Joint commission is considered as a self-governing, non-profitable organization regulated
in United States for administrating the voluntary accreditation activities for different
healthcare organizations including hospitals. Different set of standard is developed by the
joint commission to address the significant elements like medication safety, consumer rights,
patient care and infection control. There are various benefits of joint commission
accreditation in influencing the safety and quality within the healthcare industry (Moran,
Harris & Valenta, 2016). The influence of joint commission accreditation is positive in
influencing the safety and quality within the healthcare industry as they help the healthcare
organization to organize and support the effort taken for safety of the patient.
The JCA is responsible for improving risk management and also reduce any risk
possibility. The influence positive patient safety and quality by enhancing the staff members
of the organization and also developing the skill set of the staff members who are responsible
for handling the patient. They also deliver practical tool that will maintain or strengthen the
performance of the organisation in order to effectively manage the safety and quality in the
healthcare industry (Devkaran & O’Farrell, 2015).
2) The centres for Medicare and Medicaid (CMS) is responsible for regulating the healthcare
regulations that is directly related within the healthcare organization. CMS are primarily
responsible for providing government-funded medical coverage using different types of
programs like Medicare for disabled and elderly people, State Children’s Health Insurance
Program (SCHIP) health insurance coverage for the children aged below 19 and Medicaid for
the lower-income families and individuals.
Quality healthcare is considered as the highest priority of care for CMS as they are
responsible for implementing quality creativities to guarantee high quality of health care for
Medicare Beneficiaries through public disclosure and accountability. CMS practices different

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quality measures for its different quality initiatives, which includes public reporting, quality
improvement and pay for reporting. The impact of CMS on the quality and safety within the
healthcare industry is beneficial as it aims to provide a high-quality of healthcare to the
patient presented with few definite goals (Vogus & McClelland, 2016). The goals established
by CMs for maintaining the safety and quality of the patient are effective, efficient, safe,
equitable, timely care and patient-centred.
3) As the health care expenses increases, payers, comprising the Centres for Medicare and
Medicaid Services (CMS), are transferring away from the compensation based on the volume
and types of services, which will emphasize on the quality of providing care that is defined as
the value-based purchasing (VBP) (Manary et al., 2015). As value-based purchasing is
associated to compensation, VBP will produce economic motivation that will aim to measure
and develop the quality of care.
Value-Based Purchasing (VBP) is arranged without any high-level of evidence
supporting the effectiveness of the program in improving the quality within the health care.
The enhanced or increasing health care costs is considered as the factor making VBP an eye-
catching method for restraining the total costs and emphasizing on improving the quality.
Hence, VBP is expected to be considered as a more predominant procedure of compensation
for the facilities and the providers (Henkel & Maryland, 2015).

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References
Devkaran, S., & O’Farrell, P. N. (2015). The impact of hospital accreditation on quality
measures: an interrupted time series analysis. BMC health services research, 15(1),
137.
Henkel, R. J., & Maryland, P. A. (2015). The risks and rewards of value-based
reimbursement. Frontiers of health services management, 32(2), 3-16.
Manary, M., Staelin, R., Boulding, W., & Glickman, S. W. (2015). Payer mix & financial
health drive hospital quality: Implications for value-based reimbursement policies.
Behavioral Science & Policy, 1(1), 77-84.
Moran, K. M., Harris, I. B., & Valenta, A. L. (2016). Competencies for patient safety and
quality improvement: a synthesis of recommendations in influential position papers.
The Joint Commission Journal on Quality and Patient Safety, 42(4), 162-169.
Vogus, T. J., & McClelland, L. E. (2016). When the customer is the patient: Lessons from
healthcare research on patient satisfaction and service quality ratings. Human
Resource Management Review, 26(1), 37-49.