Managed Care Accreditation in the United States

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Managed Care Accreditation in the United States

Introduction

Managed care refers to the various methods used in the reduction of the costs of health care. The state of managed care in the United States has experienced a metamorphosis. As of now various companies and organizations are involved in the managed care sector. The provision of healthcare services occupies a central role in American society. As a result, there have been demands for accreditation of all service players in the sector. This has been brought about by several factors. Accreditation also involves several procedures. Apart from the fact that the process is demanding, accreditation has its benefits. The purpose of this paper is to review the state of managed care in the united states. Priority will be given to the accreditation of the players in the sector. The practice of accreditation will be discussed in detail.

Accreditation

Accreditation refers o the process in which certification is granted to an organization. This is meant to identify the organization as credible and as such having the authority to carry out operations in the area certified. Under normal circumstances, accreditation is done to identify genuine players against those who are not (Kongstvedt, 2009). This brings about quality and effectiveness in whichever sector. In the nagged care sector accreditation was mainly pushed for by the major players. Those organizations which give certification to others are themselves accredited. This is meant to foster acceptability in the process of accreditation.

Importance of accreditation

Accreditation in the healthcare industry in the United States is used to ensure competency and effectiveness in the provision of healthcare services. As a result, accreditation ensures quality healthcare services. This is done through the thorough scrutiny of various players before granting certification. Accreditation also leads to fostering genuineness in the healthcare industry. This is done by the elimination of quarks in the process. Accreditation also leads to the successful provision of healthcare services. Through the process clarity and transparency are fostered making the process of providing services successful and effective. A lot of obstacles in the effective provision of healthcare services are done away within the process of accreditation. This leads to quality services; this comes from the certification of qualified organizations only. Without accreditation, the quality of health care services will be below.

Process of accreditation

Accreditation involves certain procedures in its application. Before an organization s granted certification for the provision of service certain process has to be completed. Most of these are done to ensure that the organization deserves the certification granted to it (Goldsteen et al, 2007). The first process is the preparation for the examination, the organization seeking accreditation must first be ready for examination. This examination is done by the organization or authority issuing the accreditation. This is done to ensure that the organization meets the standards set for accreditation. Another important process is the review. At this stage, the players gather together and conduct a peer review of all their reports and applications for accreditation. This is followed by a visit examination where the organization seeking accreditation is visited and a first-hand examination is done. This is aimed at finding out whether the written reports of the organization represent the reality of facts. Judgment of the facts and granting of accreditation is then done. After this stage, the organization agrees to undergo continuous review.

The Ontario Council on community health accreditation plays a pivotal role in accreditation in the united states. The organization fosters openness and effectiveness in the provision of health services in the United States. However, the organization is mostly based in Ontario where it conducts accreditation of players in the public health sector. The organization develops and keeps accreditation standards which go a long way in ensuring accountability in the sector. The accreditation certification so offered signifies the recognition of effectiveness on the part of quality and effectiveness of service delivery.

References

Goldsteen, M. et al. (2007). Introduction to the US health care system. New York: Springer Publishing.

Kongstvedt, P. (2009). Managed care: what it is and how it works. Washington: Jones & Bartlett Learning.

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