The Accreditation Commission for Health Care (ACHC) is a United States-based non-profit health care accrediting organization. It represents an alternative to the Joint Commission and CHAP, The Community Health Accreditation Program.
ACHC was established in 1985 by home care health providers to create an accreditation option which was more focused on the needs of small providers. The process began in Raleigh, North Carolina, with the group incorporated in August 1986. The first accredited organization was awarded certification in January 1987. The company began offering services on a national level in 1996. Today, ACHC offers nine accredited programs, three of which are CMS approved (Home Health, Hospice, DMEPOS).
The Accreditation process follows a three-year accreditation cycle. The process allows for organizations to learn best practices to better serve its client base. The accreditation process starts with the organization looking at their policies and procedures and adding them to the Preliminary Evidence Report (PER) for ACHC to review. One of their surveyors will review and give required changes. Within 3–7 months an unannounced survey will take place. Once completed the organization may have some changes to make through a Plan of Correction (PoC). If the PoC is accepted the organization will be fully accredited and rewarded with the full benefits of ACHC Accreditation, they tend to be high rated
In early 2013, ACHC moved to its all-new headquarters in Cary, North Carolina. It welcomed its new CEO, José Domingos, and it launched its Behavioral Health Program.
In November 2006, the Centers for Medicare & Medicaid Services (CMS) approved ACHC to accredit suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) as meeting new quality standards under Medicare Part B. [1]
In January 2009, the Centers for Medicare & Medicaid Services (CMS) announced the approval of the ACHC for continued Deeming Authority for Home Health Agencies through 2015. [2] Initial approval of Deeming Authority of ACHC for Home Health Agencies was granted in February 2006. [3] [4]
On November 27, 2009, ACHC was recognized by the Centers for Medicare & Medicaid Services (CMS) as a national accreditation organization for Hospices that request participation in the Medicare program. [5]
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.
Dual-eligible beneficiaries refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid expenditures. Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries.
The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world.
In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers, including commercial healthcare insurers. The transition to the NPI was mandated as part of the Administrative Simplifications portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE program can provide expansive health care and social opportunities during the day while you retain the comfort and familiarity of your home outside of day hours.
This article discusses the definitions and types of home medical equipment (HME), also known as durable medical equipment (DME), and durable medical equipment and prosthetics and orthotics (DMEPOS).
Hospital accreditation has been defined as “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve”. Critically, accreditation is not just about standard-setting: there are analytical, counseling and self-improvement dimensions to the process. There are parallel issues in evidence-based medicine, quality assurance and medical ethics, and the reduction of medical error is a key role of the accreditation process. Hospital accreditation is therefore one component in the maintenance of patient safety. However, there is limited and contested evidence supporting the effectiveness of accreditation programs.
The Community Health Accreditation Partner (CHAP) is a national, independent, U.S. not-for-profit accrediting body for community-based health care organizations. CHAP is the oldest national, community-based accrediting body with more than 9,000 agencies currently accredited nationwide.
The Compliance Team (TCT) Inc., is a US for-profit organization that provides Exemplary Provider accreditation and certification services to healthcare providers across the United States. It was set up in 1994 and is based in Philadelphia, Pennsylvania.
Medicare Advantage is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Offered since passage of the BBA in 1997, Medicare Advantage/Part C creates a private insurance option that wraps around traditional Medicare, filling in many or most of the coverage gaps and including new options, resulting in a more conventional health insurance experience for Medicare recipients.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to patients and third-party payers for the quality, appropriateness and efficiency of the health care provided. According to the Centers for Medicare and Medicaid Services, an ACO is "an organization of health care practitioners that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it".
The Center for Medicare and Medicaid Innovation is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation. CMS provides healthcare coverage to more than 100 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.
Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.
Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy.
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub. L. 114–10 (text)(PDF)) commonly called the Permanent Doc Fix, is a United States statute. Revising the Balanced Budget Act of 1997, the Bipartisan Act was the largest scale change to the American health care system following the Affordable Care Act in 2010.
Deemed status is a hospital accreditation for hospitals in the United States.