Keeping an Eye on Accreditation Requirements
Legislators and regulators in states across the country are expected to move toward greater oversight and mandatory accreditation requirements for all office-based surgery in the next few years. In addition, health insurers are moving toward accreditation requirements. ACFAS members should keep this on their radar and consider the benefits of accreditation.
The State of New York created a stir – and a bit of a panic – when it enacted a law mandating accreditation of all office-based surgery practices by one of the three nationally-recognized accreditation agencies, Accreditation Association for Ambulatory Health Care (AAAHC), American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), and JCAHO, by July 1, 2009.
This is the first state that has required such broad accreditation. However, a number of states already mandate accreditation of office-based surgery facilities based on the level of sedation. California has required accreditation for outpatient facilities that administer sedation or general anesthesia since 1996. Connecticut and Ohio mandate accreditation for facilities where moderate/deep sedation or general anesthesia. Alabama encourages accreditation based on the level of anesthesia.
Each of the accreditation bodies undertakes an on-site survey of the practice based on its accreditation standards. The standards are a sub-set of the standards developed for ambulatory surgery center accreditation. The standards carry different weight based on their potential risk to patient safety. Facilities are typically given a chance to remedy violations before a final accreditation decision is made, but they must comply with all the standards to gain accreditation. Accreditation lasts for three years.
For more information on the three accreditation bodies, visit their websites:
This may or may not be the time to invest in accreditation since in most states it is not mandated (other than in those states that require it based on level of anesthesia). If you are well-positioned financially and staff wise to pursue accreditation, there are benefits to considering accreditation now. Accreditation can be a marketing tool to patients and in negotiations with health insurers – “The Good Housekeeping Seal of Approval.”
At minimum, ACFAS members should be aware of a trend toward requiring accreditation of office-based surgery. ACFAS recommends that physicians task a staff member to become familiar with the accreditation bodies and their standards so that, should accreditation be required, the office is well-positioned to gain accreditation.
Each of the organizations charges an application fee, a site-visit fee, and an accreditation fee. There is a variation in fee based on the amount of work involved in the site visit. For example, JCAHO charges $6,900 for a one-day site visit, but some surveys take longer. A conservative estimate for direct costs would be up to $10,000.