Healthcare Quality Association on Accreditation

Healthcare Quality Association on Accreditation
Name	Healthcare Quality Association on Accreditation
Abbreviation	HQAA
Formation	2009
Type	Non-profit organization
Headquarters	United States
Services	Accreditation, certification, education

Healthcare Quality Association on Accreditation is a United States-based nonprofit organization that provides accreditation and quality-assurance services to healthcare providers and ancillary services. Founded in 2009, the organization emerged amid shifts in regulatory frameworks and payer policies affecting Centers for Medicare and Medicaid Services and private payers such as Blue Cross Blue Shield plans, seeking to offer an alternative accreditation pathway to established bodies like The Joint Commission and National Committee for Quality Assurance. HQAA develops standards, conducts surveys, and awards accreditation to programs including durable medical equipment, home health, and specialty care suppliers.

History

HQAA was established in 2009 during a period of policy change influenced by Affordable Care Act debates and modifications to Medicare durable medical equipment supplier rules. Early stakeholders included stakeholders from associations such as American Association for Home Care and companies participating in Medicare Part B and Medicaid. The organization gained recognition by positioning itself alongside long-standing accreditors like The Joint Commission, Commission on Accreditation of Rehabilitation Facilities, and Accreditation Association for Ambulatory Health Care while addressing concerns arising from Centers for Medicare & Medicaid Services enforcement actions and litigation involving suppliers. Over the 2010s HQAA expanded program scope and adapted to reimbursement and compliance trends shaped by rulings from tribunals such as the United States Court of Appeals and administrative guidance from Department of Health and Human Services.

Accreditation Programs

HQAA offers multiple programmatic tracks tailored to service lines regulated under reimbursement and safety standards. These tracks include accreditation for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), home healthcare providers, private duty nursing, and specialty pharmacy suppliers that interact with payer networks like Medicare Part D and commercial pharmacy benefit managers associated with Express Scripts and CVS Health. The association also provides certification and recognized status for suppliers seeking contracts with entities such as Department of Veterans Affairs and state Medicaid programs. Its accreditation is used by entities negotiating payer contracts with national insurers including Aetna and Cigna.

Standards and Evaluation Process

HQAA develops standards through committees of clinicians, compliance officers, and industry representatives, drawing on frameworks employed by organizations such as Centers for Medicare & Medicaid Services Conditions for Coverage and guidance from Food and Drug Administration where applicable. The evaluation process typically includes self-assessment, document submission, on-site or virtual survey by trained surveyors, and corrective action plans—procedures similar to those used by National Committee for Quality Assurance and The Joint Commission. Surveyors are often licensed professionals with backgrounds linked to institutions such as American Nurses Association or academic centers like Johns Hopkins Medicine and Mayo Clinic. Accreditation decisions factor in quality indicators, patient safety practices, and billing compliance relevant to Medicare and private payer audit programs.

Impact on Healthcare Providers and Patients

For providers, HQAA accreditation can influence eligibility for contracts with major payers and participation in networks administered by entities such as Humana and regional hospital systems like Kaiser Permanente. Accreditation may also affect operational practices by aligning suppliers with policies promulgated by Centers for Medicare & Medicaid Services and legal expectations arising from decisions by Department of Justice in healthcare fraud cases. For patients, accredited suppliers are positioned to meet safety and quality expectations comparable to those advocated by consumer groups and advocacy organizations such as American Association of Retired Persons and National Patient Safety Foundation, potentially affecting access to reliable durable medical equipment and home care services.

Governance and Organizational Structure

HQAA is governed by a board of directors composed of industry executives, clinicians, and compliance professionals, with bylaws reflecting nonprofit governance practices similar to those of American Hospital Association affiliates. Committees oversee standards development, surveyor training, and appeals processes; these committees often include representatives from stakeholder organizations including American Physical Therapy Association, American Occupational Therapy Association, and state Medicaid directors. Executive leadership typically maintains liaisons with federal agencies such as Centers for Medicare & Medicaid Services and professional societies like American Medical Association for policy alignment.

Criticisms and Controversies

Critiques leveled at accreditation organizations in this sector — and sometimes directed toward HQAA — include concerns about conflicts of interest when accreditors derive revenue from entities they evaluate, a critique also applied to bodies like The Joint Commission. Legal and public scrutiny following high-profile enforcement actions involving suppliers and providers has prompted debate over the rigor and transparency of accreditation surveys, echoing controversies seen in cases involving healthcare fraud investigations by Department of Justice and policy responses from Centers for Medicare & Medicaid Services. Questions have arisen about comparative evidence supporting different accreditor outcomes, as discussed in analyses by policy think tanks and academic centers such as Brookings Institution and Urban Institute.

International Activities and Partnerships

While primarily U.S.-focused, HQAA engages with international stakeholders through partnerships and recognition arrangements, interacting with global organizations such as the World Health Organization and international accreditation bodies modeled after International Society for Quality in Health Care frameworks. These activities include sharing best practices on patient safety drawn from multinational networks and participating in conferences hosted by institutions like World Health Assembly forums and regional health quality summits.

Category:Healthcare accreditation organizations