Sunday, February 10, 2008

JCI - how much do they charge hospitals outside of the USA ?

The Joint Commission is a private company based in the USA. Its role within the USA is to survey and accredit hospitals so as to establish if they are of a high enough standard to look after patients and receive payments for such services from Medicaid and Medicare. It is not the only accreditation scheme for healthcare providers in the USA, but it is the largest.

JCI, or Joint Commission International, is the international wing of the same organisation.

JCI surveys and accredits hospitals outside of the USA, usually on a three-yearly basis, and these hospitals pay JCI for these services.

Although JCI has set up offices in places such as Singapore and Dubai, it remains a wholly American company, and all the income generated goes back to the USA.

JCI is one of a group of international accreditation schemes, including CCHSA of Canada, Trent of the United Kingdom, and ACHSI of Australia, and all are able to do a very similar job.

But how much does JCI cost ? What do they charge hospitals outside of the USA who wish to make use of their services ?

This is extremely difficult to establish, and there is virtually nothing on the internet.

The JCI web page has no information about this. The costs a hospital would incur would include:
- a fee for the survey itself
- air fares for surveyors (paid as business class level for JCI surveys conducted outside of the USA)
- a per diem for surveyors, to cover hotel costs and living costs etc.
- a fee to cover educational updates etc.
- fees to cover mock surveys prior to the genuine survey
- consultancy fees

Is there any data available on how much JCI charges so that hospitals in different countries can make some sort of comparison ?:
- Hospitals in the Philippines have suggested that the survey fee alone for an individual hospital is of the order of US$200,000 plus expenses, and that this is not the whole cost to the hospital.
- In 2005, in Singapore the fee per hospital appeared to be of the order of $30,000 per hospital, but whether or not this included other the other expenses listed above is not stated in the scanty literature available.
- In Hong Kong, the fees charged seem to have been of the order of US$60,000 per hospital surveyed. Again, this does not appear to have included the other expenses.
- In Dubai at least one hospital was quoted around $80,000 to be surveyed, again without the other expenses included.
- There is one unsubstantiated anecdotal report that after paying fees for mock surveys, real surveys and all the expenses, one Manila Hospital ended up paying more than TWO MILLION US DOLLARS for the privilege of becoming JCI accredited. It would be good to hear from JCI whether or not this is true.

Interestingly, within the USA Joint Commission surveyors are obliged to travel coach class (economy class) on flights, but outside of the USA JCI surveyors are allowed to charge for business class seats on planes. Why is this ?

Does anyone else believe that JCI and Joint Commission should publish a transparent list of fees and costs associated with using their services ? Their web site give absolutely no information about this. Publishing their charges would at least enable hospitals located outside of the USA (some in countries which are perhaps not as wealthy as the USA) to assess fairly and up front what they would have to pay to JCI.

They would also be able to assess if it would be worth them looking at other hospital accreditation options from, say, Canada, the United Kingdom and Australia, which may be just as good in terms of establishing if hospitals are safe for patients to use but may also be a lot less expensive.

The American public buy European cars and Chinese Computers. They are also buying healthcare from overseas, and there is surely little doubt that they would be prepared to look at accreditation sourced from places like Europe or Australasia. Let free enterprise rule !


Choice in accreditation said...

This is very interesting. I thought JCI was the only people in the world able to check up on hospitals, but I now know that this isnt true.

Healthcare said...

This is very interesting and and important. JCI is not cheap. Two years ago an article quoted an Indian CEO, Bomi Bhote of the Ruby Hospital in Pune,as saying "Typically, a certification like JCI requires a spending of roughly $100,000... and this is over and above any infrastructure upgradation work that may be needed." If anyone wants to see the original article it is at I think a lot of hospitals would be interested in knowing how much other hospitals are paying for the same service from JCI, and if it is worth it.

Dogan said...

Some hospitals in Turkey have paid more than half a million US dollars to get their first JCI accreditation, and they put that in their advertising.

That does seem a lot of money.

Jarah said...

Where did you find the stat about the 2 million dollar inspection?

Osman G√ľnen said...
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