by Tom Cesar

While the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) dictates that the Secretary of Health and Human Services develop quality standards for the durable medical equipment industry, the language of the law leaves interpretation wide open. Given the large number of DME providers and related organizations that must comply, it is expected that all accrediting organizations currently serving this industry will be needed to meet the requirement.

It will be up to the provider to choose an accrediting organization and to develop a strategy for becoming accredited within a relatively short period of time.

Fundamentally, accreditation is designed to establish a culture within a company that promotes sound business policies, best service and care practices, commitment to ethical conduct and methodologies that validate continual operational improvements with the overall goal of improved professionalism.

Accreditation standards provide a framework of key organizational functions, which help management effectively decrease organizational risk; create systems and processes; enhance positive business results; and deliver quality services to consumers. In the future, standards for DME accrediting organizations will incorporate all new requirements outlined by the government as the language in Medicare rules will spell out.

When and how to choose

So when should a company begin this process? Timing is tricky until HHS announces an implementation year. If determination is for a three-year implementation, providers should be making a choice of an accrediting organization in the near future. Preparation time for a small provider striving for first-time accreditation often is one year or more. Thus, identifying an accrediting organization and developing a strategy for preparation should be accomplished by early 2005. The later a company waits to seek scheduling by an accrediting organization, the later the actual survey visit will be scheduled. If HHS decides on a five-year implementation, then providers would have additional time for developing strategies.

How do you pick the right accrediting organization for your company? Consider the following questions when making your choice:

  1. Is there a comparable level of expertise with each of the accrediting organizations for DME?

  2. Are the standards relevant and specific to the providers' services mix? Is there a match; are the standards understandable?

  3. Does the accrediting organization offer good customer services, both before and after the survey?

  4. Will the accrediting process inspire the organization's motivation for continual quality improvement efforts?

  5. Does the accrediting organization provide educational and consulting site visits?

  6. Does the accrediting organization include DME representation with its governing body?

  7. What will be the impact of cost with the accrediting organization, including labor for preparation, accreditation fees, add-on fees, etc?

Also, check each accrediting organization's Web site; seek information from trade associations, buyer groups and independent consultant groups to help make your decision. Check with other providers who have experienced the accreditation process with the accrediting organizations available.

What to do after the choice

Once you select an accrediting organization, perform a self-assessment to determine your present level of compliance. Preparation time will vary with each organization depending on its resources and ability to stay focused on a systematic plan of evaluation. The standards should be used as a template to compare current company policies. To help during this phase, the accrediting organization may provide other self-assessment tools. In some cases, it may be necessary to seek an outside consultant to assist with the self-assessment and preparation for the on-site review.

It is recommended that a provider approach accreditation with a company team — one that meets regularly — to determine progress and make necessary changes to assure compliance with standards. This process takes time, but it will help identify strengths and weaknesses so that appropriate corrective actions can be implemented.

Throughout the evaluation phase, providers should maintain periodic contact with the accrediting organization for guidance. Completion of the preparation process simply means that you are able to demonstrate that your company fulfills its mission, practices what its policies state and complies with the accrediting organization standards.

Tom Cesar is president of the Accreditation Commission for Health Care Inc. (ACHC), a private, nonprofit corporation that develops accreditation standards for home care providers and alternate-site markets. For more information, contact ACHC by phone at 919/785-1214 or visit www.achc.org.

AAHomecare Accreditation Summit

On March 16 at Medtrade Spring in Las Vegas, the American Association for Homecare will present an “Accreditation Summit” featuring representatives from the Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). For more information, visit www.medtradespring.com or call 800/933-8735.