To deliver outstanding medical care to their clients, assistance companies must select top-tier medical facilities for their networks. Accreditation from reputable organisations such as Temos and the Joint Commission International (JCI) is a key indicator that a facility adheres to rigorous standards, providing safe, effective, and patient-centred care. However, is accreditation enough on its own or do assistance companies consider other factors as well? We investigate the role of accreditation and look at additional criteria that influence the selection of hospitals for inclusion in assistance networks.

Hospital perspective: the importance of accreditation

Joshua Snowden, the Director of Global Contracting at Cleveland Clinic, underscored the significance of accreditation in hospital care. “Accreditation is an important component of our Quality & Patient Safety Institute,” he said. “Cleveland Clinic is continually prepared for being surveyed in compliance with the highest levels of quality care and patient safety standards as set by the Joint Commission and many other regulatory, licensing, and accrediting agencies.”

He further explained that providing patients with detailed information enables them to make well-informed decisions about their healthcare, ensuring they receive the best possible care. “Cleveland Clinic has always been a strong advocate of informing people about specific data related to finding quality hospital care. We believe that informed patients are able to participate better in their own care. Accreditations help provide people assurances about high-quality healthcare provision,” he concluded.

Advantages for assistance companies of collaborating with accredited facilities

Jennifer Milton, the CEO and Founder of Compass Point Assist, told us that “hospital accreditation significantly impacts the decision to include a facility in a network”.

Hospital accreditation significantly impacts the decision to include a facility in a network

She reiterated that accreditation is a key indicator of a facility’s commitment to strict standards and good healthcare. “Accreditation serves as a benchmark for quality and safety standards. Accredited hospitals are recognised for meeting specific criteria related to patient care, operational efficiency, and infrastructure. This ensures a higher level of trust and reliability for both the assistance company and the travellers they support. Including accredited hospitals in the network can enhance the reputation of the assistance company and provide peace of mind to clients, knowing they will receive standardised, high-quality care.”

Mahshid Moeini, the Regional Adviser for Marm Assistance in the MENA region, agreed, echoing the critical role of accreditation in the selection process. She emphasised that accreditation by reputable organisations is a key factor they look for when evaluating and selecting medical providers. “Accreditation signifies that a hospital has met rigorous standards set by accrediting bodies, demonstrating its commitment to quality, safety, and patient care.” She explained that adhering to specific standards, protocols, and safety measures helps to ensure the best possible care, a positive patient experience, and overall customer satisfaction.

Furthermore, Moeini outlined how accreditation instils confidence in the level of care provided and benefits overall operations. “Accreditation assures insurers, assistance companies, patients, and other stakeholders that the hospital meets or exceeds certain benchmarks in areas such as clinical practices, infrastructure, infection control, and patient safety. It enhances the credibility and trustworthiness of the hospital, making it more attractive for inclusion in networks. Additionally, accreditation may also facilitate streamlined processes, such as insurance reimbursements, and contribute to improved patient outcomes and satisfaction.”

Both experts highlighted risk mitigation as another benefit of working with accredited hospitals. Milton noted: “There is a lower risk of medical errors, complications, and legal issues in accredited hospitals, which is crucial for both the assistance company and its clients.”

Moeini concurred: “By adhering to accreditation standards, hospitals mitigate risks associated with legal, regulatory, and financial issues, safeguarding their reputation and reducing potential liabilities.” She added that “working with accredited hospitals offers a range of benefits that contribute to enhanced patient care, safety, and satisfaction that creates patient experience, as well as greater efficiency and credibility in the healthcare ecosystem”. Furthermore, “accreditation encourages hospitals to engage in continuous quality improvement efforts, fostering a culture of learning, innovation, and excellence in healthcare delivery”.

Milton summarised the main advantages as quality assurance, consistency, communication, risk mitigation, trust, and credibility. However, she also recognised that new partnerships can be born when patients visit medical facilities outside of their existing network. “This situation gives us the opportunity to review new clinics and potentially add them to our network,” she said. “Working with new, non-network clinics can sometimes result in discovering unexpectedly good partners. This dynamic process helps us continually expand and improve our network of medical providers.”

Evaluating medical facilities: key criteria

The experts shared insights into the qualities they prioritise when assessing medical facilities. Moeini outlined the importance of accreditation, clinical excellence, and facilities and infrastructure. In addition, she said, the hospital’s approach to patient safety is vital. “We examine the medical provider’s protocols, procedures, and systems for infection control, risk management, and patient safety to minimise the likelihood of adverse events and medical errors.” She added that “effective communication and coordination are essential for seamless patient care. We look for medical providers that demonstrate strong communication skills, collaboration among healthcare teams, and coordination of care across different specialties and departments.” Also, she noted: “We consider factors such as the medical provider’s location, accessibility, and availability of services, including emergency care, specialised treatments, and after-hours support.”

Moeini highlighted the value of a strong reputation, explaining that Marm Assistance gathers comprehensive information about medical providers through feedback from patients, referring physicians, and other stakeholders. “Positive reviews, testimonials, and referrals indicate trustworthiness and reliability,” she said.

Moeini also reflected on compliance and ethics: “We ensure that the medical provider adheres to ethical standards, regulatory requirements, and industry best practices. Compliance with legal and ethical guidelines is essential for maintaining trust and integrity.”

Moeini continued: “By evaluating medical providers based on these standards, we aim to ensure the delivery of high-quality, safe, and patient-centred healthcare services to our clients.”

Milton also identified clinical excellence, patient safety, operational efficiency, infrastructure and technology, patient experience, reputation, and compliance with regulations as crucial factors. Additionally, she said, local knowledge and accepting the company’s Guarantee of Payment (GOP) are other criteria they look for. She explained that adhering to the company’s GOP facilitates the financial transaction process for customers, enhancing both efficiency and customer satisfaction. 

Accreditation encourages hospitals to engage in continuous quality improvement efforts, fostering a culture of learning, innovation, and excellence

Beyond accreditation: additional due diligence

Although accreditation is highly regarded, the experts revealed that most assistance providers conduct their own due diligence to ensure facilities meet the needs and standards of both the company and its customers.

Even for accredited hospitals, ongoing monitoring and feedback collection from patients and healthcare professionals are essential to ensure consistent quality of care

Milton explained: “Accreditation provides initial assurance of the hospital’s quality, making it more likely to be trusted in urgent or unfamiliar situations.” However, she noted that the assistance company would still conduct its own due diligence to evaluate specific needs, “such as the hospital’s capability to handle particular medical conditions, language proficiency of staff, and alignment with the company’s service protocols”.

Moeini agreed, stating: “While accreditation by organisations like Temos or JCI is valuable and provides a level of assurance regarding the quality of care at a hospital, assistance companies typically conduct their own due diligence as well. Accreditation is an important factor, but it’s not the sole determinant of the quality of care.

“Assistance companies often have their own criteria and processes for evaluating medical providers, which may include factors beyond accreditation,” she continued.  “This could involve assessing the hospital’s facilities, medical staff qualifications, patient feedback, and previous experiences with the hospital. Additionally, the specific needs and preferences of the insured individual also play a role in the evaluation process.”

Moeini said that while including accredited hospitals in its network is a priority for Marm Assistance, conducting additional due diligence creates “a comprehensive approach that helps to mitigate risks and ensures the highest standards of quality and safety for the insured individual”.

In addition to initial assessments, Milton stressed the need for continuous monitoring. “Even for accredited hospitals, ongoing monitoring and feedback collection from patients and healthcare professionals are essential to ensure consistent quality of care,” she said.

Drawing on a previous point, she noted: “Ideally, communication from patients before hospital visits allows steering them to known, networked facilities with verified quality.” However, when customers seek treatment at hospitals outside the network, this can provide an opportunity for establishing new partnerships.

Shedding light on the practical realities, Milton concluded: “While due diligence is important, the assistance company recognises the vastness of the world and the impracticality of personally reviewing every facility. Therefore, reliance on accreditation reviews is sometimes necessary.”

Conclusion

While accreditation is a fundamental pillar of quality assurance in hospital selection, it is complemented by a thorough evaluation process that involves both initial assessments and continuous monitoring. Assistance companies often integrate additional criteria – such as provider experience, customer feedback, and specific details about the facility and staff – to ensure a comprehensive evaluation. Despite this, accreditation remains a strong indicator that clients will receive top-notch care. This multifaceted approach enables assistance companies to establish reliable networks of esteemed healthcare providers, ensuring high standards of care and improving overall patient outcomes.