The Medicare Hospital Certification System Needs Reform

HRD-79-37: Published: May 14, 1979. Publicly Released: May 14, 1979.

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The Department of Health, Education and Welfare (HEW) is required by law to certify that all hospitals participating in the Medicare program are providing quality care to patients. Hospitals accredited by the Joint Commission on Accreditation of Hospitals (JCAH) are automatically certified except for two requirements.

The certification system has problems caused by a limited capacity to measure the quality of hospital care, differences in standards used by HEW and JCAH, differences in how states and JCAH conduct surveys and apply standards, and ineffective monitoring of states' activities. HEW must improve its policy guidance and monitoring activities at all levels, including controls for discovering and correcting weaknesses in JCAH, the regional offices, and the states.

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