You’re ready to enroll with Medicare, but there’s one big decision standing in your way: Which accreditor should you choose?
Many home health and hospice owners feel overwhelmed comparing accrediting bodies. Costs, survey timelines, and customer service styles vary widely. And no one wants to be surprised by hidden fees or strict standards they didn’t anticipate.
*This article was written in consultation with Mariam Treystman.
At The Home Health Consultant, we’ve helped hundreds of agencies navigate the accreditation process. We've heard agency opinions and experiences with each of the three accreditors for home health and hospice agencies:
- Accreditation Commission for Health Care (ACHC)
- Community Health Accreditation Partner (CHAP)
- The Joint Commission (TJC)
In this article, we’ll break down the key questions to ask before choosing your accreditor, so you can make the best decision for your agency’s operations, team, and budget.
What Is the Total Cost of Accreditation Over Three Years?
Many agencies ask about initial survey costs. But the real question is: what will accreditation cost you over the entire three-year cycle.
- Initial enrollment survey fees are often similar between accreditors.
- Resurvey fees (for your renewal every three years) can differ by thousands.
- For example, some accreditors like Joint Commission charge an annual fee plus survey fees, while others like ACHC do not.
What to Ask the Accreditor: What are your enrollment fees, annual fees, and resurvey fees over a three-year cycle?
Does Accreditation Provide Return on Investment in Your Referral Area?
In some states, hospitals prefer agencies accredited by specific bodies, like The Joint Commission (TJC). However, in many areas today:
- Referral sources do not have a strong preference between accreditors.
- Accreditation is mandatory for Medicare participation, making the “prestige” of any one accreditor less relevant.
What to Ask Yourself: Do my main referral partners prefer one accreditor over another?
What Is Their Account Management and Customer Service Style?
Each accreditor has a different approach to account management. For example, in our experience:
- Joint Commission: Very tech-focused, portal-based, minimal human contact.
- CHAP: More personalized, frequent human interaction, but response times can vary.
- ACHC: A hybrid approach – portal resources with human contact when needed.
What to Ask the Accreditor: How do agencies interact with account reps? Is communication mostly through portals, calls, or emails?
What to Ask Yourself: Do you prefer self-service or human support for compliance questions?
What Is the Attitude of Their Surveyors?
All surveyors cite deficiencies if they find them, but survey experiences vary. For example, in our experience:
- Joint Commission: Surveyors often take a strict, formal approach.
- ACHC and CHAP: Surveyors tend to be more educational and collaborative, explaining best practices while still citing deficiencies.
What to Ask Others in the Industry: What has been your experience with your surveyors’ attitudes and approach?
How Long Is Their Typical Survey and What Standards Do They Enforce?
Survey length and scope can impact your stress, operations, and payroll.
- Some accreditors survey for two days, others for three days or more.
- All enforce Medicare Conditions of Participation, but some add time to assess their own additional standards.
What to Ask the Accreditor:
- How long is a typical survey for agencies of my size and type?
- How many additional standards do you require beyond Medicare Conditions of Participation?
How Does Their Scheduling Process Work for Surveys?
Timing is critical, especially for agencies enrolling with Medicare. All accreditors used to allow agencies to submit blackout or block dates. Block dates were days you could request no survey on.
For example, let’s say an agency owner was getting married on April 7th. The agency would be able to request April 7th as a block date, so a surveyor wouldn’t arrive while the owner was not present.
CMS no longer allows block dates to prevent unannounced surveys during personal events. However, some accreditors may have alternate methods for accommodating critical situations if asked.
What to Ask the Accreditor:
- How soon after submitting my readiness date do surveys typically occur?
- What is your policy on scheduling around major agency or owner events?
What Holidays Do They Survey On?
Some accreditors survey on certain holidays; others do not. This impacts your staffing and readiness planning. Knowing an accreditor's holiday schedule before you decide to work with them is essential.
What to Ask the Accreditor: Which holidays do you avoid scheduling surveys on?
Why Choosing the Right Accreditor Sets Your Agency Up for Success
Choosing an accreditor isn’t just about initial survey fees. Consider total costs, survey timelines, customer service styles, surveyor approach, additional standards, and scheduling policies.
No matter who you choose, Medicare requires agencies to remain compliant at all times. However, the accreditor that best matches your needs can make this process smoother and less stressful.
Before choosing your accreditor:
- Ask these critical questions.
- Talk to other agency owners about their experiences.
- Reflect on your agency’s operations, referral market, and team preferences.
For a great resource on what to do after passing your accreditation survey, check out the article below. By knowing what to expect during the early timeline of your agency, you’ll be set up for success.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
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