In May, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announced that it was selling analysis of accredited hospitals’ data to14 Blue Cross/Blue Shield health plans covering 29 states, and plans to expand its access to and use of hospitals’ patient-level data. For hospitals, this action raises three extremely serious issues and has triggered ongoing discussions between JCAHO and the American Hospital Association (AHA).
- Health Insurance Portability and Accountability Act (HIPAA) compliance issues raised by JCAHO’s plans to seek patient-level data from accredited hospitals and its use unrelated to accreditation.
- Necessity for JCAHO separately to collect patient-level performance data that duplicates the Hospital Quality Alliance’s efforts.
- Apparent conflicts created when JCAHO, as an accrediting body, sells data analyses to insurance companies and other third parties.
During these discussions, significant differences in opinion have emerged over how the HIPAA requirements affect JCAHO’s proposed plans to access and use patient-level data from hospitals in its announced strategy to “over the long haul …[become] a purveyor of performance data analysis for a variety of purposes.”