Choosing a Managed Care Company, Essay Example

The accreditation of a healthcare facility is essential to provide the highest quality of care and treatment for all patients. Various accreditation organizations provide a number of criteria that must be met to achieve this distinction, and this plays a role in securing the contractual services of a managed care organization (Scanlon and Hendrix, 1998). The latter’s focus on quality of care and treatment enables organizations to take full advantage of their accolades and to acquire the services of the chosen managed care group at the desired level (Scanlon and Hendrix, 1998). Performance criteria enable an organization to improve their negotiation strategy when looking to contract with a managed care organization (Scanlon and Hendrix, 1998). Performance data also provide further evidence that an accredited organization is fully prepared to negotiate with a managed care company to achieve mutually beneficial outcomes (ACMQ.org). In other words, accreditation provides a number of benefits to an organization, but it also further satisfies the requirement to positively impact managed care contracts and overall patient care more effectively (ACMQ.org). The performance data derived from an accredited organization provides a basis for the development of new factors which may further expand knowledge and improve the quality of care that is received, while also considering the means by which managed care is successfully integrated into this type of organization (ACMQ.org). It is expected that there must be an approach in place that will enable the managed care organization to develop a strong level of trust and acceptance of the accredited organization and its policies, procedures, and standards for achieving excellence in patient care across all clinical divisions and departments.

References

ACMQ.org. Policy 26: requirements of accrediting organizations that certify health care entities. Retrieved from http://www.acmq.org/policies/policy26.pdf

Scanlon, D.P., and Hendrix, T.J. (1998). Health plan accreditation: NCQA, JCAHO, or both? Managed Care Quarterly, 6(4): 52-61.