In September of 2024, the U.S. Department of Health and Human Services (HHS) published its stamp of approval for telehealth accreditation programs. With federal backing, this may be an inflection point for telehealth accreditation programs. Although not currently required in meaningful ways by federal and state regulators, that could change as the telehealth market is expected to grow in the near future. Likewise, the growth of telehealth accreditation highlights an interesting dynamic between competing national accreditation organizations.
HHS Endorsement of Telehealth Accreditation
In what is believed to be a first, HHS effectively published an endorsement of telehealth accreditation programs. On September 16, 2024, HHS updated its “Best practice guides” website, which provides useful information on telehealth services, including recommendations on billing and strategy issues. In this recent update, HHS added the page “Telehealth accreditation,” describing in more detail the basics of telehealth accreditation and advantage of achieving such a designation. As HHS notes, “Telehealth accreditations helps ensure that telehealth programs adhere to standards, evidence-based best practices, and regulations.” HHS outlines the advantages of telehealth accreditation, including its promotion of trust and confidence in telehealth programs, alignment with regulatory and legal best practices, risk mitigation, improved quality and processes, and measurement of performance.
Increased Interest in Telehealth Accreditation Market
Healthcare accreditation organizations updated their telehealth programs in response to the early days of the COVID-19 pandemic. For many years, URAC was seen as the nation’s leading telehealth accreditor. In early 2020, notably before the onset of the pandemic, URAC purchased the programs of ClearHealth Quality Institute (CHQI) and acquired their telehealth offerings. At the time, it was reported as the “two most prominent accrediting bodies for telehealth” combining their programs.
Recently, as the telehealth industry has matured, other entrants joined the market, such as the Joint Commission and the National Committee for Quality Assurance (NCQA). However, as pointed out by STAT, it has not always been clear how much value telehealth companies see in accreditation. Yet now, with the strong backing by HHS, this calculus may change. Additionally, described by STAT, the growth of telehealth technology may require regulators across the country to adopt accreditation requirements to maintain levels of quality.
Telehealth Highlights Larger Accreditation Competition
The competition between the Joint Commission, NCQA, and URAC in the telehealth market will be an interesting storyline to play out. It is not clear if the telehealth market can sustain multiple major accreditors, and each already is seen as a market leader in non-telehealth industries, such as hospitals for the Joint Commission, health plans for NCQA, and pharmacies for URAC. The Joint Commission and NCQA remain the two dominant accreditors, with the Joint Commission’s recent revenue reporting in at just over $200 million, and NCQA’s at nearly $100 million, according to its 2023 990 form. URAC comes in as a smaller market player with $23 million in revenue, as reported by the organization’s 2023 990 form.
But it appears dynamics between the three are not always correlated with revenue size. Hill and administration staffers have pointed out that URAC’s status has increased through its notable uptick in public policy work. In recent years the organization established itself as a national policy leader among accreditors. While URAC was previously lesser known than more recognized accreditors like the Joint Commission and NCQA, URAC elevated its image through efforts to promote accreditation in the telehealth and mental health policy spaces. Likewise, the organization’s CEO Dr. Shawn Griffin has seen his D.C. profile rise, with frequent media coverage and reported advocacy on behalf of the accreditation industry. He joins Margaret E. O’Kane, founder and president of NCQA, as one of the major accreditation players in the health policy world.
Dr. Griffin’s recent comments in Modern Healthcare effectively articulate the state of the accreditation race in telehealth. “’There are other organizations that offer telemedicine accreditation, and for that we say congratulations […] We believe in competition. We believe that consumers and providers need to have choices as to who they do accreditations with. We’re excited for more high quality organizations to come into this space and provide opportunities to make sure that patients get the care that they need.’” We will certainly be monitoring its development moving forward.