How Quality Measures Differ Across Accrediting Agencies

Introduction

Healthcare accreditation in 2025 is characterized by a significant shift toward outcome-based data and digital health integration. While all major accrediting bodies—such as The Joint Commission (TJC), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the National Committee for Quality Assurance (NCQA)—share the goal of improving patient safety, they differ fundamentally in their philosophy, scope, and specific quality metrics. Understanding these differences is essential for organizations to align their internal quality improvement efforts with the specific expectations of their chosen accreditor. In the current landscape, the choice of an agency often dictates whether a practice focuses on rigid medical safety protocols or holistic, person-centered outcomes.

Comparing Accreditation Pathways

Choosing the right accrediting body is an important decision for healthcare facilities. Organizations often analyze AAAHC vs Joint Commission to determine which aligns best with their services, size, and regulatory needs. Both offer rigorous standards, but differ in scope, cost, and survey processes. Understanding these differences helps leaders select an accreditation path that supports quality improvement and reimbursement eligibility. Accreditation strengthens credibility, improves operational consistency, and demonstrates commitment to patient safety. Careful evaluation ensures the chosen organization supports long-term strategic and clinical goals.

The Medical and Compliance Model: The Joint Commission (TJC)

The Joint Commission is traditionally viewed as the most rigorous and medical-driven accrediting body. In late 2025, TJC launched its Accreditation 360 model, which emphasizes continuous engagement over episodic surveys. Its quality measures are heavily weighted toward clinical safety and hospital operational performance. TJC requires organizations to report on specific National Performance Goals, which superseded the previous National Patient Safety Goals in July 2025. These measures focus on high-acuity risks such as accurate patient identification, medication management safety, and suicide risk assessment. For hospitals, TJC’s ORYX® initiative integrates performance data directly into the accreditation process, requiring standardized reporting on electronic clinical quality measures (eCQMs).

The Person-Centered and Consultative Model: CARF

In contrast to the prescriptive nature of TJC, CARF utilizes a consultative, peer-driven approach that is particularly popular in behavioral health and rehabilitation settings. CARF’s quality measures focus on the "lived experience" of the patient and the measurable results of services. Instead of strictly mandated safety protocols, CARF asks organizations to demonstrate how they involve the persons served in their own care planning. A key differentiator is CARF’s modular flexibility; an agency can choose to accredit a single program—such as an outpatient substance abuse unit—rather than the entire organization. In 2025, CARF intensified its requirements for Measurement-Informed Care (MIC), requiring providers to use standardized tools like the PHQ-9 or GAD-7 to track real-time patient progress.

The Data and Population Health Model: NCQA

The National Committee for Quality Assurance (NCQA) is primarily focused on health plans and physician networks, utilizing the Healthcare Effectiveness Data and Information Set (HEDIS) as its primary quality measure tool. While TJC looks at the facility and CARF looks at the program, NCQA looks at the data. NCQA measures are highly quantitative and focus on population health management, such as the percentage of members receiving preventive screenings or managing chronic conditions like diabetes. In 2025, NCQA introduced new Health Outcomes Accreditation standards that move beyond administrative reporting to look at actual clinical improvements across large patient populations, emphasizing digital quality and data exchange integrity.

Key Differences in Quality Reporting and Scope

The administrative burden and reporting frequency vary significantly across these agencies. TJC has recently moved toward a more streamlined approach by removing over 700 redundant requirements to focus on high-impact safety goals, yet it remains the most comprehensive in its review of organizational governance. CARF requires an Annual Quality Report and focuses on "conformance" to standards that the organization defines for itself based on its mission. NCQA follows a strict annual reporting cycle for HEDIS data, often requiring health plans to submit vast amounts of medical record data to verify quality scores. These differences mean that an organization's choice of accreditor will fundamentally shape its administrative daily life and its definition of "success."

Conclusion

As healthcare continues to evolve toward value-based care in 2025, the differences between accrediting agencies are becoming more pronounced. The Joint Commission remains the gold standard for facilities seeking to demonstrate high-level medical safety and compliance with federal regulations. CARF offers a more flexible and holistic path for organizations that prioritize individual patient outcomes and program-specific excellence. Meanwhile, NCQA remains the dominant force for health plans where data accuracy and population-wide health trends are the primary metrics of quality. Ultimately, the "best" accrediting agency is the one whose quality measures most closely align with the clinical philosophy and operational reality of the healthcare provider.