AAAHC Celebrates 30th Anniversary, Growth of Ambulatory Health Care Industry

Nation’s Largest Ambulatory Health Care Accrediting Organization Reflects on History, Trends

Skokie, Ill. [March 10, 2009] — The Accreditation Association for Ambulatory Health Care (AAAHC, Accreditation Association) marks on March 22, 2009, the 30th anniversary of its founding as the nation's first accrediting body for ambulatory health care organizations. It remains the nation's largest ambulatory health care accrediting organization, with more than 4,000 organizations now accredited worldwide.

"Since 1979, the AAAHC has reflected the ongoing evolution and growth of the ambulatory health care industry, while ensuring ever-higher standards for quality patient care," said John Burke, PhD, Executive Director and Chief Executive Officer. "We continue to take a forward-looking approach in the services we offer. For example, this year we have introduced new standards specifically for behavioral health, lithotripsy services, and medical home – the new frontiers in ambulatory accreditation."


Founded to Provide Quality-Focused Peer-Based Review

The Accreditation Association grew out of the efforts of several national organizations that recognized a need for accreditation specifically developed for ambulatory organizations. An important early contributor was the American Group Practice Association (AGPA, now the American Medical Group Association).

"The trend was driven by board certified physicians in group practices who wanted their groups to be similarly certified," said Marshall Baker, MS, FACMPE, who represents the Medical Group Management Association on the AAAHC Board of Directors. Baker is chair of the AAAHC standards committee and one of the Accreditation Association’s longest-serving surveyors – performing his first survey (as an AAMC Surveyor) in 1978.

"From the beginning, the physicians felt it was important to be judged by their peers: physicians, nurses, administrators and others. This peer-based approach is unique, and remains the hallmark of the AAAHC," Baker said.

In addition to the AGPA, other charter members of the AAAHC were the American College Health Association, the Federated Ambulatory Surgery Association (now the Ambulatory Surgery Center Association), the Group Health Association of America, the Medical Group Management Association, and the National Association of Community Health Centers.


Reflecting Changing Trends in Ambulatory Care

"In the early years, community and college health centers and large medical clinics were the largest segment of the health care community accredited by the AAAHC," said Bernard Kershner, who became a member of the AAAHC Board in 1981. Kershner is chairman of Health Resources International, West Hartford, Conn., and founding and current chair of the AAAHC Institute for Quality Improvement. "In later years, ambulatory surgery centers (ASCs) that are discreet organizations, separate from hospitals, saw explosive growth, which underscored the need for ensuring quality through accreditation."

According to the Centers for Disease Control and Prevention, the number of ASCs rose from 239 in 1983 to more than 3,300 nearly two decades later. The number of procedures performed in ASCs rose from 380,000 in 1983 to 57.1 million in 2006.

"Other organizations that are now accredited by the AAAHC include Indian health centers and U.S. Air Force and Coast Guard ambulatory care facilities," Kershner said.


Thirty Years of Evolving Standards

"Throughout our history, AAAHC has been committed to promoting high standards for ambulatory health care services, and to adjusting our standards to reflect the latest advances in the field," Burke said. “We look forward to continuing to meet the needs of the ever-changing ambulatory environment in the years to come."

The Evolution of the Accreditation Association for Ambulatory Health Care: A Timeline of Accomplishment for Quality Patient Care

Mid-1960s – American Group Practice Association (AGPA) begins national discussion to establish accreditation of medical group practices.

1967 – The American College Health Association (ACHA) launches a certification program for member college and university health centers.

1968 – AGPA forms Commission on Accreditation and begins development of standards and methods to apply standards to evaluate quality of ambulatory health care.

1969 – AGPA Commission conducts first on-site visits and awards first certificates of accreditation.

1979 – Medical Group Management Association (MGMA) is invited to participate in survey process.

Late 1960s – Mid-1970s – Focus of nation's health care system begins to shift from hospital to ambulatory settings. Grants from federal government fund new centers for primary care as the number of community health centers and surgical centers begins to grow. These organizations find themselves ineligible to participate in existing accreditation programs.

1975 – The Accreditation Council for Ambulatory Health Care is organized by the Joint Commission on Accreditation of Hospitals (JCAH), the AGPA, American Medical Association, Group Health Association of America and the MGMA.

1975 – The Society for the Advancement of Freestanding Ambulatory Surgical Care (later this became the Federated Ambulatory Surgery Association, FASA) develops an accreditation program for ambulatory surgery centers.

1978 – The Joint Commission decides to dissolve its accreditation councils and replace them with professional and technical advisory committees. Representatives from the founding organizations of the Accreditation Council for Ambulatory Health Care, seeking to retain responsibility for the accreditation process, withdraw from the JCAH program and move to form a new accrediting body.

1979 – The Accreditation Association for Ambulatory Health Care, Inc. is incorporated in Illinois as a not-for-profit organization on March 22. Its purpose is to organize and operate a peer-based assessment, education and accreditation program for ambulatory health care. The six charter members of the corporation are the ACHA, AGPA (now the American Medical Group Association), FASA (now the Ambulatory Surgery Center Association), the Group Health Association of America (now the American Association of Health Plans), the MGMA and the National Association of Community Health Centers. Each of the organizations designates the AAAHC as its national accrediting body.

1982 – The Outpatient Ophthalmic Surgery Society is added as a new member organization of the AAAHC.

1983 – The American Academy of Facial, Plastic and Reconstructive Surgery, the National Association of Freestanding Emergency Centers (now the National Association for Ambulatory Care), and the Society for Office Based Surgery (now the American Society of Outpatient Surgeons) are accepted for membership on the AAAHC Board of Directors.

1983 – The AAAHC begins its program for surveying and accrediting managed care organizations.

1987 – The American Occupational Medical Association (now the American College of Occupational and Environmental Medicine) joins the AAAHC. The American Academy of Dental Group Practice votes to discontinue its own accreditation program for dental group practices and becomes an AAAHC member.

1989 – The American Association of Oral and Maxillofacial Surgeons, the American Academy of Cosmetic Surgery and the Association of Freestanding Radiation Oncology Centers join the AAAHC.

1993 – The American Society for Dermatologic Surgery becomes a member organization.

1994 – The AAAHC amends its bylaws to allow one or more public members to serve on the AAAHC Board.

1995 – The American Medical Association and the American Dental Association, at the invitation of the AAAHC, begin sending official observers to meetings of the Accreditation Association’s Board of Directors.

1996 – The Centers for Medicare & Medicaid Services (CMS) confer deemed status on the AAAHC for Medicare certification for ambulatory surgery centers.

1999 – Representatives of the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Society of Anesthesiologists, Society for Ambulatory Anesthesia and the American Academy of Dermatology become AAAHC board members.

1999 – The Accreditation Association establishes the AAAHC Institute for Quality Improvement to provide ambulatory health care organizations opportunities to participate in quality improvement and performance measurement studies and educational programs.

2004 – The American Gastroenterological Association becomes a member of the AAAHC Board. The AAAHC begins to accredit U.S. Coast Guard ambulatory health care facilities.

2005 – The American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy join as AAAHC Board members.

2006 – The United States Air Force selects the AAAHC as the accrediting organization for its ambulatory health care facilities worldwide.

2007 – CMS again recognizes the AAAHC and its accreditation program by renewing deemed status for health maintenance organizations and preferred provider organizations that participate in the Medicare Advantage program.

2009 – The Accreditation Association adds new Standards chapters for behavioral health, lithotripsy services and medical home. The AAAHC celebrates its 30th anniversary, now accrediting more than 4,000 ambulatory organizations. Current member organizations of the AAAHC Board include the Ambulatory Surgery Foundation, American Academy of Cosmetic Surgery, American Academy of Dental Group Practice, American Academy of Dermatology, American Academy of Facial Plastic and Reconstructive Surgery, American Association of Oral and Maxillofacial Surgeons, American College of Gastroenterology, American College Health Association, American College of Mohs Surgery, American College of Obstetricians and Gynecologists, American Gastroenterological Association, American Society of Anesthesiologists, American Society for Dermatologic Surgery, American Society for Dermatologic Surgery, American Society for Gastrointestinal Endoscopy, Medical Group Management Association and the Society for Ambulatory Anesthesia.