This month, Behavioral Healthcare talked to four behavioral health accrediting organizations, two of which — The Joint Commission and CARF — named new executive directors — Michael Johnson and Tracy Griffin Collander — to head their behavioral health accreditation programs just this year. They, together with Brett Welch of ACHC and Patricia Barrett of NCQA, shared their views about health reform and its impact on accreditation-related products and offerings.
There are many payers and managed care organizations that are looking at accreditation as a means of assuring the quality of providers, says Britt Welch, Behavioral Health Clinical Manager with the Accreditation Commission for Health Care (ACHC), which offers Behavioral Health Accreditation for psychiatric home care, case management, community support, day treatment, outpatient treatment, and psychosocial rehabilitation. “I’m hearing more and more about states looking at accreditation standards as a way of reducing some licensing requirements,” he says, adding that these states are establishing a deeming process whereby accredited providers are considered as having met select state standards.
States are also depending on more managed care organizations (MCOs) to manage Medicaid programs, another important factor in the increased demand for accreditation. Often the MCOs are using performance-based contracting, says Welch. “They’re also looking at providers’ ability to integrate behavioral health and medical care,” he adds, noting that this is a national trend. “Integration, sometimes called bi-directional care, can lead to cost savings and improved outcomes,” says Welch.
Integrated care can also be a means for overcoming the effects of stigma, which can prevent people from accessing appropriate care, says Welch. “Many people with a mental illness will go in to see their therapist. But if they have to go to another location for physical care, they may not go for any number of reasons,” he says. “If you can bring behavioral health and medical care under one roof, you can improve overall outcomes.”
In response to this trend, Cary, North Carolina-based ACHC has standards that are specific to integrated care. These standards can apply to a behavioral health practice that is trying to integrate medical aspects of care, or to a primary care practice that is integrating behavioral health, says Welch. “We are also in the development of health home standards.”
Health homes are a key concept in the Affordable Care Act. These organizations encourage patients to get all of their medical needs met, or at least coordinated, in one place.
“We also have standards that address supportive employment,” says Welch. “It’s more than just the healthcare piece,” he adds, noting that people with behavioral health concerns have needs that go outside traditional medical services, such as housing and employment.
The total ACHC accreditation fee depends on the complexity of the organization, the number of locations, and the types of services offered. A $1,500 deposit is applied toward that amount.
ACHC was established 27 years ago when a group of private duty nursing providers in North Carolina wanted standards that fit better with what they did on a day-in day-out basis, says Welch. “Over the years we have added a variety of accreditation offerings, such as home health and hospice, durable medical equipment, prosthetic fitting services, retail pharmacy, specialty pharmacy, and convenient care,” he says. Behavioral health accreditation is one of ACHC’s newer offerings.
ACHC’s accreditation is for three years. Accreditation decisions include: accredited, deferred, dependent, or accreditation denied. “We do require a plan of correction if there are areas of deficiency,” says Welch. “To better assist our customers, we have tried to take the guesswork out of developing plans of correction,” he says. ACHC is specific about what the deficiency is, and helps guide providers in what needs to be corrected. “We provide that information through on-site education and in the summary of findings report, which is sent to the provider following the on-site survey,” says Welch. “We also supply providers with a plan-of-correction template.”