Managed Care

Managed Care Essay Sample

As the number of health care facilities increase, it becomes difficult for an individual to ascertain which one to choose. If a facility is accredited by some officially approved body then at least the customer has something to judge by when selecting a health care facility. Accreditation is mainly a voluntary system, in which a neutral organization reviews the quality of service provided by an organization.  The process makes certain that the duty performed by the company is done according to certain minimum standards established.

       The importance of accreditation cannot be underestimated.  An accredited company sends the signal to the community that its standards of quality are maintained while encouraging healthy competition in the market. An accredited company will be favored over an unaccredited one simply because they meet the standard set by a neutral organization. Accreditation makes certain that patient safety levels are bettered, negligence is at its lowest, and staff training may be enhanced. Also, an accreditation may satisfy regulatory requirements needed for licensing or help in reducing insurance premiums.

        There are numerous organizations which accredit health services in the United Stated, namely The Joint Commission, the oldest and biggest standards setting and accrediting body responsible for accrediting more than 17000 organizations. Then there is Utilization Review Accreditation Commission (URAC), Accreditation Association for Ambulatory Health Care (AAAHC) and the National Committee for Quality Assurance (NCQA), to name just a few.

Before accreditation can be awarded there is a multistep process that has to be passed by the organization seeking accreditation. The first step in the process is a self assessment by the organization itself, next comes the location visit by volunteer surveyors, who are all professionals chosen only after they meet the requirements of the accrediting body. After the site survey, accreditation is awarded based on the recommendations of the surveyors and information collected at the site.  Depending on how well the organization meets with the compliance standards, accreditation is awarded form three months to three years, after which it needs to be reviewed.

       Tricare is a health care plan that provides health care services to active or retired service members and their families through military health care facilities and civilian networks. Tricare requires that all facilities in their system have JCAHO (Joint Commission on the Accreditation of Healthcare Organizations) accreditation. Some of their standards cover environmental concerns, “Environment of Care”standard, others include “Human Resources” (HR) or “Leadership” (LD) standards. The JCAHO accreditation institutes yardsticks for crux business practices and the care agenda which includes disease management, consumer protection, and confidentiality. The accreditation is valid for up to three years, two for laboratories, after which it needs to be renewed. Individuals using Tricare facilities displaying JACHO accreditation know the service they are getting is compatible to any available in the market, and they are not shortchanged.

REFERENCES

 Joint Commission Fact Sheets. November13, 2000.  Retrieved May 25, 2010, form http://www.jointcommission.org/

Accreditation: what’s the big deal? – managed care organizations., December1995. by Barbara Sande Dimmitt http://findarticles.com/p/articles/mim0903/is_n12_v13/ai_17875512/

 

“All Hands” Magazine.  August 97 edition. Retrieved from tp://usmilitary.about.com/library/milinfo/allhands/bltricare.htm

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