Do Health Care Providers Quality Discriminate? Empirical Evidence from Primary Care Outpatient Clinics

Robert Rosenman, Daniel Friesner and Christopher Stevens
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Daniel Friesner: Gonzaga University
Christopher Stevens: Ohio University, Eastern Campus

Eastern Economic Journal, 2005, vol. 31, issue 4, 649-670

Abstract: There has been minimal attention paid to the mechanisms of hospital quality oversight that are currently in place. Accordingly this study will analyze the system of hospital quality regulation in the US. The Social Security Act as amended in 1965 gave the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) "deeming" power for Medicare quality requirements. There are numerous reasons why JCAHO's oversight strategy may be ineffective. The primary reason is the dual role of JCAHO as a regulator and advocate. In conclusion, JCAHO surveys do provide an incentive to hospitals to improve processes of care for the period leading up to an inspection and that incentive gets eliminated after the inspection occurs. JCAHO has announced a change from the scheduled survey to an unannounced strategy. The objective of this change is to provide an incentive to maintain a level of readiness. This may not occur if hospitals are motivated to minimize the overall cost of JCAHO compliance.

Date: 2005
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