Five Reasons for Substance Use Treatment Providers to Become Accredited

Substance use disorder treatment providers have many reasons to seek national accreditation and to benefit from this process. Whether seeking accreditation from The Joint Commission, CARF International, Council on Accreditation (a division of Social Current), Accreditation Commission for Health Care (ACHC), or other, here are 5 top reasons to become accredited:

Reason #1 – Promotes Quality Treatment in a Safe and Healthy Environment

An external survey of quality and safety conducted by well-trained professional accrediting body surveyors provides reassurance and builds trust for the individual, family, or referral source seeking a treatment resource. The accreditation hallmark distinguishes a treatment resource as going beyond minimum state licensing standards. Accrediting bodies promote accredited organizations on their websites so that parents, individuals, and healthcare professionals can easily identify treatment resources with the accreditation hallmark of distinction.

Reason #2 – Strengthens Business Practices

Accreditation standards address ethical marketing practices, require transparency in plans and policies, look for actions taken based on staff and consumer feedback, and promotes equity in treatment based on the person’s needs.

Reason #3 – Standardizes Administrative and Clinical Processes

Accreditation supports consistent delivery of good care to every consumer. It requires a multi-dimensional assessment (best practice) so that each consumer is receiving exactly the care and treatment needed by competent and qualified staff. The standardization of processes provides a framework for increasing service capacity, allowing for expansion of levels of care, new programs and services, and treatment at additional locations.

Reason #4 – Expands Reimbursement Options

Accreditation is increasingly being used as an indicator of quality by third-party payers as a condition of substance use treatment payment approval. Private, commercial insurance companies, and managed care entities require accreditation to become an “approved” provider. The accreditation hallmark of quality and safety may also result in more diversified referral sources as healthcare professionals recognize the organization’s commitment to quality and safety.

Reason #5 – Supports Efficient and Effective Billing

Being reimbursed in a timely manner is a critical business practice component for any substance use treatment provider. The clinical documentation required by accrediting bodies supports and justifies admissions (medical necessity of services), level of care, treatment interventions, continued stay/treatment, and transfer or discharge. This type of clinical documentation reduces denials of reimbursement or provides the documentation needed for appeals of denials.

The results of a recent study of Joint Commission accredited organizations by ROI Institute supports National Accreditation and identifies returns on accreditation investment.

If you are ready to reap the benefits of accreditation for your organization, or if you have questions about the process, please contact us.

 

For more information or questions about the contents of this article, please write or call Peggy Lavin @ Peggy@AccreditationGuru.com / 847.219.1296.

This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

How Accreditation Supports Recovery Principles

The national accrediting bodies have been among the moving forces in the integration of the recovery model into the care, treatment and services for people with mental health and/or substance use disorders. Recovery principles can now be seen throughout behavioral health standards of accrediting bodies as well as the outlined expectations that an organization will demonstrate conformance/compliance to these standards. And, the integration makes sense – this model not only complements the more traditional model of medication and “talk” therapies, but also expands the focus to include the person’s own goals and strengths and empowers them to be actively involved in the process.

The US Substance Abuse and Mental Health Administration (SAMHSA) has also integrated the recovery model in their publications, requirements for certified community-based behavioral health clinics, training materials, and grants. To that end – they’ve developed the Working Definition of Recovery. Several of the guiding principles shown here are addressed in the accrediting bodies’ standards.

Accrediting bodies’ implementation of such a model involves workforce training so that staff can fully understand and embody the organization’s philosophy, thus permeating service delivery to positively impact the recovery of the people served.  In addition, the accreditation survey process itself supports the recovery principles. Surveyor(s) not only review written documents, but also observe interactions amongst staff at all levels and persons served and share their observations with the organization. This external survey can confirm, enhance, and strengthen the organization’s intent and commitment to recovery principles

While accreditation as a whole supports the recovery model, below are specific examples of ways in which accreditation and the recovery model intersect:

Person-Driven – An individualized plan of care, treatment, and services based on the needs, strengths and abilities, preferences/expectations and goals of each person being provided care, treatment or services is a core accreditation requirement. “Boiler plate” plans that repeat over and over the same information for each person served will result in survey findings (unsatisfactory conformance/noncompliance with standards) and the need for correction to achieve full accreditation. Furthermore, it’s an expectation that an accredited organization actively involve the person served in identifying their needs and preferences for aftercare and, as much as possible, making choices about where, type, and by whom.

Holistic – The needs of the person in relation to various life domains, such as physical health and housing, are addressed in case management/care coordination standards (assessment of the person’s needs and assistance in meeting these identified life domain needs). Since access to routine and needed physical health care can be a challenge for those who need it, the accrediting bodies offer options for the integration/coordination of physical health care. Health Home standards have been established to facilitate successful integration of physical health care with an organization’s traditional behavioral health programs.

Culture and Respect – Accreditation standards emphasize that the person served encounters respect in all aspects of their care, treatment, or service experience and this is reflected in the organization’s policies, procedures, rules, and expectations as well as the rights and responsibilities of the person served. Standards clearly emphasize that service delivery is provided by staff in an atmosphere of respect and understanding and sensitivity to cultural values, beliefs, and preferences.

Trauma – The approach of the accrediting bodies to trauma centers around their screening and assessment, planning and delivery of services, and workforce training standards. Standards require a screening and assessment process to identify people whose lived experiences either currently and/or in the past may have included trauma(s). Also, organizations need to demonstrate that the impact of trauma on the person served is considered in the planning and delivery of care, treatment, or services.

Peer Support – Peer support services are an important component of the recovery model. These services are part of the plan of care, treatment, or services, and are provided by trained individuals who share similar lived experiences with mental health and substance use challenges. Accrediting bodies not only recognize the utilization of this type of service by mental health and substance use treatment providers, but also have developed standards addressing the integration of these services into the planning of care with the active involvement of the person served.

The accrediting bodies require written plans, policies, or procedures promoting these recovery principles to form a framework for implementation and a communication to staff and people served of the philosophy, beliefs, and values of an organization.

For more information on the recovery model and/or how accreditation can benefit your organization, visit AccreditationGuru.com.

 

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Performance Measurement and the Growing Need for Metrics

 

One of the central components of national accreditation is the focus on performance and quality improvement (PQI) programs. This is the process of collecting, aggregating and analyzing data to discover trends and patterns and make improvements (or expand upon achievements) where necessary. However, it is not just the accrediting bodies, but funders, licensing organizations and individual donors who are looking for data on outcomes to help demonstrate mission fulfillment.

Nonprofits are increasingly being held accountable for measuring their service outcomes. And for health and behavioral service providers, the focus on process – or fee-for-service arrangements – is obsolete: the new priority centers on positive patient results, which must be documented.

As the saying goes, “what cannot be measured, cannot be improved.”

If you have questions about how Accreditation Guru can help your organization develop a robust performance improvement process, please contact us at 212.209.0240 or Info@AccreditationGuru.com.

Is Your Organization Staying Competitive in Today’s Environment?

In today’s increasingly competitive environment, health and human service organizations often struggle to distinguish themselves. Providing high quality services is a given, but to establish your brand, you must demonstrate that you make a difference in the lives of those you serve.

Some critical factors that can help maintain your organization’s competitive edge include earning national accreditation, reporting on service outcomes (not just outputs) and recruiting and maintaining a qualified, well-trained workforce.

Accreditation

Achieving accreditation affirms that child welfare, behavioral health, employment and community service organizations meet or exceed professional-grade quality standards in service delivery. It also gives clients and other key stakeholders an appropriate tool for effectively evaluating service providers.

Organizations that earn accreditation reach beyond minimum licensing standards and make a long-term commitment to strong governance, program consistency, outcome measurements and continuous improvement throughout their agencies.

Accreditation requires organizations to undergo an objective review by an independent accrediting body. The designation signifies that agencies effectively manage their resources and enhance the quality of life of the population served.

Individuals and families increasingly regard the accredited status of an agency as an important factor when considering where to seek services.*

Performance Improvement and Reporting on Outcomes

With detailed digital data available just a few clicks away, health and human service organizations are being held accountable for measuring service outcomes – not just outputs. This new development requires the collection and analysis of relevant data to discover trends and patterns. The key is to make improvements (or expand upon achievements) where necessary.

Outputs are quantifiable data points related to the numbers of people served, frequency of home visits made, time in care and other common variables. However, outputs measure the impact that services have on the lives of those in care or treatment, including knowledge transferred, behaviors changed, improved homelife stability and other revealing and quantifiable data points.

In fact, all organizations seeking to gain and maintain accreditation are required to record and report outcome statistics as part of their performance improvement programs. Compiling performance indicators in a transparent, easy to understand manner will help service providers connect with clients, families and donors in a meaningful way and, in turn, allow them to be more competitive.

In the nonprofit arena, the relationship with donors has been forever transformed by technology and the unyielding desire for increased information that supports educated giving decisions. Providing reports on outcomes can also help non-profits tell their story and compete for hard-won donor dollars.

Qualified Workforce

Recruiting and retaining a well-trained, qualified workforce is the key to providing high quality services, reducing operational and programmatic risk, maintaining an organization’s reputation and contributing to institutional stability.

To attract talented employees, agencies should institute standardized recruiting procedures, conduct primary-source verification of education and licensure, perform background checks and review criminal history records for those individuals who work directly with vulnerable or at-risk people and develop effective onboarding processes.

In the health and human service field, top-quality employees aim to work for nationally accredited entities, an achievement that demonstrates your organization’s commitment to quality and to investing in its workforce.

It is easier to retain a qualified workforce by focusing on training, staff satisfaction, professional development and transparency. Investing in your people will foster a more stable workforce and enhance the quality of provided services – all of which helps make your organization more competitive.

Summary

Implementing steps to retain your organization’s competitive edge takes time and effort, but think about the alternatives: If you neglect the opportunity to continually improve, your reputation will ultimately suffer.

Earning national accreditation provides a framework for improving operations, measuring and reporting on outcomes, recruiting and supporting employees and providing quality services – which help maintain your organization’s competitiveness in an ever-changing environment.

For assistance preparing for national accreditation, or with any of the items mentioned in this article, please contact us at Info@AccreditationGuru.com.

* See our article on using accreditation as a marketing tool for more information.

Team Member Highlight – Tracy Collander

Tracy Collander

Tracy first became familiar with the accreditation world when she began working for Gateway Foundation in 2007.  Gateway Foundation is accredited by The Joint Commission, and she became familiar with TJC behavioral health accreditation during her 6 years as executive director for Gateway Aurora.

Her knowledge of accreditation became much stronger as she became Executive Director of The Joint Commissions Behavioral Health accreditation program, as she had the opportunity to work closely with the accreditation team, behavioral healthcare leaders, and advisory members.  Now that she is back in the field, she continues to value accreditation as a road map to leading a safe, high quality organization.  She believes this is critical for engaging a team that is invested in providing the best care possible to people in need.  Her Joint Commission experience has been so valuable to her as a leader – it reinforces her resolve to provide the best possible leadership to her team in support of the care that people deserve to receive.

She enjoys spending time with her two teenage boys, husband, and dog.  Her boys are both involved in sports, so much of their free time is spent cheering on their baseball/basketball teams locally or on the road.  When at home, they love watching movies together or hanging out with friends.

She also enjoys outdoor activities – gardening, walking her dog, running, golfing…boating when they have a chance to get to a lake… hiking when she visits her brother in Oregon or sister in Arizona…and skiing when it snows in the Midwest or when they travel to visit her siblings.  Both her husband and Tracy are from big families, so there is often a birthday, holiday, or other event to celebrate as well!

When she has downtime, she loves to read (or listen to books on Audible when driving), particularly suspense books, historical fiction novels, and leadership books.

We are happy to have Tracy on the Accreditation Guru team!

Are You Measuring Your Service Outcomes? You Should Be!

According to a recent study in the International Journal for Quality in Health Care, “what cannot be measured, cannot be improved.”

With detailed digital data available just a few clicks away, non-profits are being held accountable for measuring their service outcomes. In fact, all organizations seeking to gain and maintain accreditation are required to record and report outcome statistics as part of their performance improvement programs.

For example, while The Joint Commission has always required organizations to assess outcomes of care, treatment or services, organizations are now required to accomplish this through the use of a standardized tool or instrument.  By utilizing “measurement-based care,” The Joint Commission “believes these standards enhancements will help accredited customers meet the growing demand to demonstrate the value of their services and increase the quality of the care, treatment, or services they provide.”

For health and behavioral service providers, the focus on process – or fee-for-service arrangements – is obsolete: the new priority centers on positive patient results, which must be documented.

This approach rejects fee-for-service reimbursement, where “individual providers are incentivized to order more tests and procedures and manage more patients in order to get paid more, regardless of patient outcomes,” according to the New England Journal of Medicine.

Value- and performance-based models aim to rein in ballooning costs. The outcome-based orientation is partially designed to help lower spending.

Another broad goal is to improve care and help patients efficiently navigate the health care system. Collaboration and customized services are replacing the top-down model, where experts determine the procedures and patients follow along.

Many major insurance companies are reorienting their reimbursement schedule to reflect this data-driven model. According to national accrediting body CARF, Cigna, Aetna and U. S. Healthcare plan to increase value-based payments to as much as 90 percent of all reimbursement spending in the next few years.

Beyond private insurance companies, state and federal mandates are also pushing patient care toward outcome-based services.

The Centers for Medicare & Medicaid Services (CMS) has begun implementing value-based changes, for example. Under Section 223 of the federal Protecting Access to Medicare Act, moreover, the Substance Abuse and Mental Health Services Administration initiated a pilot program in eight states to introduce value-based outcomes in certified community behavioral health clinics.

The program includes technical specifications and data-reporting templates requiring the collection of 21 measurable data points.

Participating states are mandated to “collect and report on encounter, clinical outcomes, and quality improvement data,” according to CMS. “The statute also requires annual reporting by the states that will entail collection of data which can be used to assess the impact of the demonstration program.”

In addition, fee-for-service reimbursement is being replaced by the prospective payment system (PPS), which is based on the quality of care rather than services provided.

Another new initiative implemented by CMS, Bundled Payments for Care Improvement, links “payments for the multiple services beneficiaries receive during an episode of care.” Acute care hospitals, skilled nursing facilities, home health care agencies and inpatient rehabilitation facilities, “enter into payment arrangements that include financial and performance accountability for episodes of care.”

CARF reports that state regulators are also spurring the shift toward performance-based models and criteria by promoting prevention and methods that consider social determinants of heath.

“The future is undoubtedly in favor of providers that can implement strong performance management practices,” according to CARF. Agencies that reorient their practices in this new direction will be well-positioned to achieve and maintain accreditation status.

Contact Accreditation Guru to help put your organization on course to thrive in this brave new world of outcome-based measurement.

The Alliance’s New “Operations Support Services”

As a partner of the Alliance for Strong Families and Communities, Accreditation Guru is excited to share with you their new and game-changing “Operations Support Services” offering for the nonprofit sector. This offering is intended to help leaders address provision of operations support services related to human resources, finance, administrative operations, and more. This is available to ALL nonprofits in the United States, not just Alliance member organizations.

Across the country, daily tasks, ranging from detailed budget reports to regular donor stewardship, siphon limited energy and resources that could be better directed toward program implementation. Because dollars available for overhead functions are particularly scarce, nonprofits should look for smart ways to maximize these resources. For organizations that cannot cost-effectively sustain internal capacity and expertise in administrative functions, the gap will continually widen and plague their abilities to focus and execute on their missions.

The Alliance is dedicated to helping community-based organizations (CBOs) bolster their approach to risk management, improve the effectiveness of fund usage, and understand the benefit of shared services—all of which allow for an increased focus on mission and people served. The “Operations Support Services” offering was created to help fulfill the five identified “North Star” initiatives in the landmark report, “A National Imperative: Joining Forces to Strengthen Human Services in America,” by the Alliance for Strong Families and Communities and the American Public Human Services Association.

By partnering with the Alliance, CBOs can outsource various financial and administrative duties for which internal capacity and resources may be limited. As part of this new venture, the Alliance also is offering competitive and robust benefits packages, enhanced retirement planning services, and comprehensive EAP and work-life services to their employees at a reasonable cost, regardless of their size. In addition, the Alliance’s unemployment tax program combats hidden expenses, avoids claims volatility, and enables better management of cash flow and claim tracking.

The Alliance has established many strategic partnerships to facilitate provision of operations support services that can be customized for any size nonprofit:

  • Flexible accounting and bookkeeping assistance delivered directly by Alliance staff
  • Comprehensive, competitively priced group health insurance packages offered via industry
    leaders that cover thousands of companies and hundreds of thousands of lives
  • Employee assistance and work-life services from FEI Behavioral Health, the Alliance’s
    social enterprise
  • The ability to provide a wide range of retirement plans and planning services to employees,
    with the added value of no administrative fees
  • A cost-effective alternative to the state unemployment tax system
  • Access to group purchasing savings programs

“Along with our expertise in human resources, finance, and administrative operations, it is our intent to enhance and expand our support services to help leaders address needs related to fundraising and development; marketing, public relations, and communications; and information technology,” explains Lenore Schell, Alliance senior vice president of strategic business innovation.
For more information, visit the Alliance’s website.