Available via license: CC BY-NC
Content may be subject to copyright.
The McNerney Forum
Jeptha W. Dalston
Lawrence D. Prybil
Howard Berman
John S. Lloyd
Transforming the
Accreditation of Health
Care Management
Education
Recognizing the considerable changes occurring over recent years in health care, the
Accrediting Commission on Education for Health Services Administration (ACEHSA)
sought to remake itself to become a more vital participant in the field. This article reports the
rationale, objectives, and process pursued by ACEHSA as it underwent this transformation
and adopted a new name: Commission on Accreditation of Healthcare Management
Education (CAHME). This paper features the planning document adopted to lead CAHME
through the future. It also highlights actions taken to date and subsequent steps planned.
‘‘Change is the law of life. And those who
look only to the past or present are cer-
tain to miss the future.’’
— John Fitzgerald Kennedy
The enormous changes in health care over the
1990s and into this century jarred all components
of the field. Accreditation of health administra-
tion education did not escape these sea change
impacts. Rather, accreditation found itself weak-
ened and largely disconnected from its lifelines,
adrift in past practices, and in dire need of updat-
ing, revitalizing, and strengthening.
Through recognition of these factors, the cor-
porate sponsors, Board of Commissioners, and
other leaders of the Accrediting Commission on
Education for Health Services Administration
(ACEHSA)—the single accrediting authority for
graduate education in health administration since
1968—concluded that the commission must act
boldly and swiftly. Boldness and swiftness
are not strong suits of educational settings; only
survival of the commission buoyed a sense of
mandate and urgency. Thus came about a com-
mitment with fervor to transform the commission.
This article reports the rationale, objectives, and
process pursued by ACEHSA to transform itself.
Background information emphasizes the context
for the transformation and explains the adoption
of a new central planning and implementing doc-
ument, ‘‘Building the Profession Through Quality
and Value for Health Administration Education
and Practice: A Strategic Blueprint for the Fu-
ture.’’ The article includes a summary of actions
taken to date, the next steps contemplated, and
a statement on the outlook for the future. The syn-
opsis is followed by the document as adopted.
Background
The corporate sponsors, commissioners, manage-
ment and other stakeholders of ACEHSA set out
to develop a bold but practical strategy for trans-
Jeptha W. Dalston, Ph.D., F.A.C.H.E., is president and CEO of HealthExec, Inc., former president and CEO of the Asso-
ciation of University Programs in Health Administration (AUPHA), and former president and CEO of the Accrediting Com-
mission on Education for Health Services Administration. Lawrence D. Prybil, Ph.D., F.A.C.H.E., is a professor in
the College of Public Health, University of Iowa. Howard Berman, M.H.A., is vice chairman of the Lifetime Healthcare
Companies. John S. Lloyd, M.B.A., M.P.H., is president and CEO of the Commission on Accreditation of Healthcare
Management Education (CAHME). Address correspondence to Dr. Dalston at 3333 Eastside Drive, Suite 220, Houston,
TX 77098. Email: wim@flash.net
Inquiry 42: 320–334 (Winter 2005/2006). Ó 2005 Excellus Health Plan, Inc.
0046-9580/06/4204–0320
www.inquiryjournal.org
forming the accreditation of health administration
education. The commission organized a task
group in the summer of 2003 to design and rec-
ommend a strategy for accomplishing this mas-
sive task. The report of the task group was
approved in November 2003, during a joint ses-
sion of ACEHSA’s corporate sponsors and the
organization’s Board of Commissioners.
This report constituted a preliminary proposal
for fundamentally strengthening the governance,
finance, standards, processes, and relationships
of the commission. The proposal was approved
for broad-scale consideration by those in the
health care education field. Core objectives of
the proposed plan were: 1) to relate academicians
and practitioners more closely and continuously;
2) to streamline the accreditation processes; 3)
to relate accreditation standards more closely
and more quickly to dynamics of the field; and
4) to strengthen the capabilities of and perfor-
mance by the commission.
The ‘‘Strategic Blueprint,’’ as the document
came to be called, was discussed, dissected, de-
bated, vetted, and refined extensively from Janu-
ary to June 2004. The refined Strategic Blueprint
paper was approved for implementation by all the
ACEHSA corporate sponsors. The last corporate
sponsor to approve the plan was the Association
of University Programs in Health Administration
(AUPHA), which did so through action by its
Board of Directors with concurrence of its mem-
bership during the AUPHA annual meeting in
early June 2004. Later that month, formal action
was taken by the ACEHSA corporate sponsors
and the Board of Commissioners to adopt the
Strategic Blueprint. Implementation then pro-
ceeded, following the framework and guidelines
laid out in the new document.
A New Name
The plan for transforming the commission fo-
cused upon strengthening the profession through
enhancing quality and value of health administra-
tion education and practice. Though developed
by ACEHSA, the plan called for renaming
the commission the ‘‘Commission on Accredita-
tion of Healthcare Management Education’’ or
CAHME. The rationale for this name change is
explained in detail in the document, which is fea-
tured at the end of this paper.
Translating the CAHME Vision into Action
Similar to the plans drawn by an architect, the
construction manager makes modifications to
meet the requirements of the site and the owner.
Shortly after the completion of the Strategic
Blueprint, the building of CAHME began. An
interim board of directors made up of ACEHSA
commissioners and members of the old board
of sponsors came together in mid-2004. This
group decided on four specific priorities that it
wished to accomplish as quickly as feasible:
h Continue smooth operations of the accredi-
tation process utilizing existing ACEHSA
standards;
h Recruit a solid core of founding corporate
sponsors;
h Complete the essential steps of the corpo-
rate restructuring outlined in the Strategic
Blueprint, which included codifying the name
change, writing new bylaws, meeting legal
requirements of the original corporate charter
in the state of Illinois, and complying with the
official recognition policies of the U.S. De-
partment of Education and the Council on
Higher Education Accreditation;
h Conduct and successfully complete a search
for a new president and chief executive officer.
Since adequate resources for ACEHSA were
a continuing challenge, considerable effort was
directed at identifying ‘‘founding corporate spon-
sors’’ who would be willing to commit $20,000
for three successive years to create a stable oper-
ating base. The membership committee was able
to recruit an initial group of 11. As of May 16,
2005, at which time the first annual meeting took
place, a total of 19 corporate members—out of
a target of 30—had been secured. Professional as-
sociation members include: the American College
of Healthcare Executives, American College of
Medical Practice Executives, American Hospital
Association, American Health Information Man-
agement Association, American Society of
Health-System Pharmacy, Association of Univer-
sity Programs in Health Administration, Blue
Cross Blue Shield Association, Federation of
American Hospitals, Healthcare Financial Man-
agement Association, Medical Group Practice
Association, and Health Information and Man-
agement Systems Society. Market organization
members include: Ascension Health, Catholic
Health Care Management Education
321
Health Partners, National Center for Healthcare
Leadership, Hospital Corporation of America,
Scripps Health, St. Luke’s Episcopal Health Sys-
tem, Sutter Health, and Texas Health Resources.
At the first annual meeting, the corporate
members met and ratified the name change,
new purpose and bylaws, and elected a permanent
Board of Directors. In addition to these two im-
portant steps, during the first year of implementa-
tion of the Strategic Blueprint the commission
accomplished the following:
h Reaffirmed Accreditation Council policies,
procedures and processes;
h Established the Standards Council’s charge
and appointed its membership;
h Continued ongoing program pre-accredita-
tion and accreditation activities with indis-
tinguishable interruptions;
h Recruited a new president and chief execu-
tive officer;
h Adopted a strategic implementation plan
called ‘‘Metrics for Success,’’ which built
upon the earlier Strategic Blueprint reported
in this article.
Based on direction from ‘‘Metrics for Suc-
cess,’’ the initial recommendations for the Ac-
creditation Council were to:
h Review existing accreditation criteria and
recommend changes to be implemented by
January 2006;
h Develop a plan to improve effectiveness and
efficiency of the site visit process by spring
2006;
h Develop a comprehensive database by May
2006;
h Review and improve the site survey evalua-
tion instrument by May 2006.
The recommendations for the Standards Coun-
cil included these initial objectives:
h Establish a Standards Council (Dr. Tom
Royer, CEO of Christus Health, was chosen
as the first chair among 10 members, with
equal representation from academe and the
market/profession sectors);
h Complete, review, and publish revised accred-
itation criteria by June 2006 to be implemented
for the academic year starting in August 2009;
h Continuously review standards to ensure
complete review every four years.
In June 2005, the Standards Council met in
Dallas to begin the process of not only defining
what it means to be a ‘‘premier accrediting
agency,’’ but also defining how the standards re-
view process would proceed. In July, the Accred-
itation Council began a series of working sessions
designed to improve current accreditation pro-
cesses, work flows, and service to programs.
While a great deal has been accomplished,
much remains to be done. The CAHME Board
of Directors is working diligently to meet the ex-
pectations of the health care field. The Strategic
Blueprint report laid out the guidelines for
change, and construction is well underway. To en-
sure that we are designing a system that works,
CAHME is providing opportunities for input from
graduate programs, corporate members, and the
health care field broadly. A series of ‘‘town meet-
ings’’ are scheduled for 2006 to give professionals
an opportunity to comment on the work of the
councils.
When a change occurs as significant as the one
that turned ACEHSA into CAHME, it is important
to assure that change is actually improvement. The
Board of Directors is endeavoring to see that
CAHME accreditation is meaningful, not only to
the graduate programs but also to the students
and families who rely on the accreditation ‘‘mark’’
in making crucial career decisions.
The value of accreditation to programs is im-
provement in processes and quality. CAHME is
aware that potential employers of graduates of
CAHME-accredited programs expect these peo-
ple to be fully prepared for demanding career po-
sitions. Much more needs to be done to prove to
all parties that CAHME has become a ‘‘premier
accrediting agency,’’ and that CAHME accredita-
tion is valuable.
The Strategic Blueprint
What follows is the document as approved by the
ACEHSA governing body in June 2004.
INTRODUCTION
Both opportunities and imperatives challenge
leaders in education and practice within the
healthcare
1
field. Opportunities arise from major
new pressures for quality, awareness that major
improvements are needed in health management
education, and mounting motivation for change.
The imperatives focus upon much-publicized
Inquiry/Volume 42, Winter 2005/2006
322
healthcare systemwide deficiencies, coupled with
a demand for enhanced management perfor-
mance. The needs are compelling and the mo-
ment is now.
As a national resource for assuring and en-
hancing quality in healthcare management
education, the Accrediting Commission must
assume a leadership role in quality through its
accreditation standards with accompanying in-
fluence and authority. To do so, however, the
Commission itself must become more efficient,
financially sound, and broadly reconfigured.
As an initial step in that direction, ACEHSA
formulated a Joint Task Group (JTG) through
discussion accompanied by a sense of urgency
during the spring meeting in April 2003 of the
ACEHSA Corporate Sponsors and Board of
Commissioners.
2
The premise that accreditation can and should
play a leading role in meeting today’s challenges
is supported by the recently completed report of
the Blue Ribbon Task Force on Accreditation
(BRTF).
3
This report presents both a framework
and specific recommendations for accreditation
that provide a background and build a foundation
upon which changes can be implemented. The
elements of this paper which relate directly to
BRTF recommendations are cross-referenced.
4
The Strategic Blueprint paper also incorporates
major components of the BRTF report as well
as the perspectives of the Commissioners, Corpo-
rate Sponsors and AUPHA members.
THE IMPERATIVE FOR TRANSFORMING
ACEHSA
The external forces affecting the healthcare field
in the latter part of the 20
th
century have created
the need for important changes to occur in
healthcare management education and practice.
These changes have required a shift in emphasis
and a need for expanded skill sets among practi-
tioners. Healthcare organizations have also ex-
perienced severe financial constraints and have
reduced their investments in management devel-
opment activities. Opportunities for residencies,
fellowships, and related management develop-
ment activities have suffered. Dialogue between
academics and practitioners has also declined
in a period when better communication is essen-
tial. The cumulative effect of these changes has
been a blurring of career pathways and a loss
of the sense of purpose that has been a feature
of healthcare management practice. There is no
common agreement on standards for what con-
stitutes a ‘‘traditional’’ career or for appropriate
career development activities.
Additionally, values anchored in concern for
improving the health of individuals and popula-
tions have often been compromised in the debate
about whether organizations should emphasize
the ‘‘bottom line’’ or the mission. The need for
transforming ACEHSA derives from a desire to
strengthen the healthcare management education
process by reinforcing the original values of the
field: leadership with a humanitarian bent; ded-
ication to community service; emphasis on men-
toring; and commitment to high quality care.
These values must underpin healthcare manage-
ment practice whatever the setting, service or
organizational type.
Concern about the skill sets required of health-
care management executives also must be ad-
dressed. The Accrediting Commission must join
others in aggressively strengthening the field of
practice in order to enhance the contribution of
healthcare management to the public it serves.
One benefit of transforming ACEHSA is identifi-
cation of healthcare management core compe-
tencies for use by healthcare management
education programs. The Commission can use
these core competencies to facilitate significant
changes in curriculum development and curricu-
lum design and to engender renewed emphasis
on educational outcomes.
The National Summit Conference, ‘‘National
Summit on the Future of Education and Practice
in Health Management and Policy,’’ in Orlando,
Florida, initiated constructive dialogue between
academics and practitioners. It provided an op-
portunity for both groups to come together and
rebuild a sense of community around common is-
sues and concerns. This revitalized sense of com-
munity promises a new era of energy,
commitment, and creative approaches. The pro-
posed transformation of ACEHSA described in
this document is an important beginning toward
fulfilling the promise of improving healthcare
management education.
TRANSFORMATION OF ACEHSA INTO
CAHME
For both substantive and symbolic reasons, it was
Health Care Management Education
323
recommended that the name of ACEHSA be
changed. Substantively, the name change recog-
nizes that some accredited programs now pursue
missions that focus on other than health services
delivery. While the transformed ACEHSA re-
spects traditional missions oriented to health
services delivery, it also recognizes the value of
missions in addition to health services delivery.
Symbolically, movement to a new name is an im-
portant expression of the seriousness of intent and
far-reaching nature of the transformed initiative.
Accordingly, this paper sets forth a new name
for ACEHSA. The new name is designated as the
Commission on Accreditation of Healthcare
Management Education (CAHME). The term
‘‘healthcare’’ is recommended rather than health
services to reflect that our concern is not just the
delivery of health and medical services to patients
but also the broader concern for the health of
communities and populations. In addition, the
term management is used to reflect the broad in-
volvement in setting strategic direction for organi-
zations and ensuring that planning activities are
realized through strategic management activities.
OBJECTIVES OF THE TRANSFORMATION
The objectives to be achieved by this initiative
are as follows (see BRTF Recommendation
R1 and R20):
h Set into place a new vision for ACEHSA
that will serve as a vehicle for reinventing it
and identifying new goals that better address
the compelling needs of the healthcare system.
h Enhance connection with essential compo-
nents of the healthcare field, especially
practitioners, payers, and suppliers.
h Strengthen the ACEHSA governance func-
tion.
h Improve the efficiency and effectiveness
of the accreditation process, establishing
ACEHSA as a recognized leader in accred-
itation methodology and practice.
h Enhance the timeliness, currency, and posi-
tive impact of the accreditation criteria.
h Reposition ACEHSA so as to be financially
strong.
THE VISION FOR CAHME
(See BRTF Recommendation R1)
The following represents the future envisioned
for healthcare management education accredi-
tation and the transformed CAHME. Timelines
for accomplishing components of the vision
will be determined by the CAHME Board
of Directors.
CAHME will be recognized and respected as
a premier accreditation agency in the field of
higher education. It will be seen as an innovator
in accreditation processes, techniques and best
practices. The educational programs it accredits,
the universities in which they are located, and the
practitioner community will view the CAHME
accreditation process as highly efficient, effec-
tive, meaningful, and valuable. CAHME will
serve as an authoritative source for qualita-
tive benchmarks for healthcare management
education.
There will be tangible evidence to show that
CAHME contributes substantially to improving
the quality of healthcare management and lead-
ership in North America, with measurable bench-
marks against which progress can be assessed
and performance improved.
The priorities of CAHME and the educational
programs it accredits will demonstrate strong
commitment to improving the health of individu-
als, families, communities, and populations
through improving the organization, manage-
ment, and delivery of healthcare services and
products.
CAHME will be known as an innovator and
actively promote quality innovations in learning,
such as distance and experimental learning and
other pedagogical developments.
Through a combination of accreditation fees,
grants, philanthropic gifts, and sponsorship sup-
port, CAHME will have solid financial founda-
tions and sound financial operations.
The preceding vision statement suggests that
the cornerstone for the future of healthcare man-
agement will emphasize integrity, strength, and
competence. These characteristics coupled with
the legacy of healthcare management rich in val-
ues and commitment serve as basic underpin-
nings for the CAHME vision.
This vision also suggests that CAHME accred-
itation standards, processes and values will serve
as standard bearers for academic education. Ac-
creditation of health administration academic
programs will stand shoulder to shoulder with
and will become a leader among other higher ed-
ucation accreditation agencies. CAHME will also
Inquiry/Volume 42, Winter 2005/2006
324
be seen as a role model for other components of
healthcare management in terms of the values
we cherish and our process of efficiency.
This future will allow healthcare management
accreditation to contribute substantially to qual-
ity patient services and to fulfill expectations of
the practicing community across the growing
healthcare field. CAHME will be viewed as a peer
by major healthcare organizations, professional
societies and trade associations as this future
is realized.
REVIEW AND VETTING
In moving toward definitive recommendations of
a far-reaching, much needed transformation of
ACEHSA, the JTG recognized that extensive re-
view and vetting of the paper would improve its
quality and pave the way to broad-scale support.
Accordingly, the document was conveyed in draft
form to constituents of the Corporate Sponsors in
December 2003. There followed review during
early 2004 of the paper by each Corporate Spon-
sor in its own method and timing.
Particular effort was made by AUPHA leader-
ship to inform, solicit reaction and recommend
modifications during January and February
2004. Also, the ACEHSA Board of Commis-
sioners deliberated and offered suggestions for
refinements during this time. Other Corporate
Sponsors also expressed their views.
This activity resulted in development of a
revised draft that was the object of a focused
discussion during the Academic-Practitioner
Conference on March 3, 2004, in Chicago at
the American College of Healthcare Executives
(ACHE) Congress on Healthcare Management.
Constituents of multiple Corporate Sponsors
were present but particularly those of AUPHA.
Spirited and constructive discussion resulted in
ideas/suggestions for further refinements. Based
on this cumulative feedback, the ACEHSA Board
of Commissioners made additional improve-
ments and voted unanimous approval of the doc-
ument in late June 2004. The current document is
a result of this extended development process.
STRUCTURE OF CAHME
A. Corporate Structure
The governance structure of ACEHSA will be re-
organized with the new CAHME becoming the
corporate entity and a Board of Directors its sin-
gle governing body. This requires, of course, a
revision in the current ACEHSA articles of
incorporation and bylaws. The current dual gov-
ernance structure of ACEHSA consisting of the
Corporate Sponsors and the Board of Commis-
sioners will be supplanted by a successor entity,
described in the next section, which has full
fiduciary responsibility for the enterprise. Conti-
nuity will be assured by including governing
authority members from existing Corporate
Sponsors, current ACEHSA Commissioners,
and others familiar with ACEHSA accreditation
processes.
B. CAHME Corporate Membership
Components (See BRTF Recommendation R16)
Corporate membership of the new CAHME will
be comprised of three co-equal components that
comprise the Corporate Members [with vote]
and a set of invited organizations as At-Large
Members [without vote]:
1. The Market—This component is defined as
those or ganizations that are the major
sources of employment of health management
education graduates.
2. The Profession—This component is defined
as those organizations that focus upon life-
long education, leadership development,
career maintenance, career enhancement,
and advancement of the interests of health-
care.
3. Academia—This component is defined as
those organizations that formally train the
health services managers/leaders and offer
formal undergraduate, graduate, and/or doc-
torate degrees.
4. At-Large Members—This component is de-
fined as those organizations that are impor-
tant and integral operating entities of the
healthcare field that by nature of their
mission are limited in resources but rich in
purpose. This special membe r c ategory
serves to provide balance to the new CAHME
consistent with the general composition of the
healthcare field.
Of the organizations within the components
outlined in 1 through 4, those that become Cor-
porate Members of CAHME initially will be des-
Health Care Management Education
325
ignated as founding members of CAHME. Exam-
ples of each of the four membership components
noted here appear in the next section.
C. Numbers of CAHME Corporate Members
with Examples
1. The Market—Approximately 15 organiza-
tions will be invited f rom the Market
component to become Corporate Members
of CAHME. These members will be drawn
from a broad spectrum of healthcare organi-
zations including health systems, medical
group practices, health care plans, health-
care consulting firms, pharmaceutical com-
panies and medical supplier/medical device
corporations, and related types of organiza-
tions. These Corporate Members as a group
will be the source of up to five persons to
serve on the Board of Directors on a stag-
gered term basis.
2. The Profession—Approximately 15 organi-
zations of the Profession component will be
invited to become Corporate Members of
the CAHME. These organizations will be
drawn from a broad spectrum of profes-
sional organizations in health administration
related to hospital and health system man-
agement, medical group management, health-
care financial and information management,
healthcare c onsulting, trade associations,
quality-oriented organizations, and national
management development entities. These
organizations as a group will be the source
of up to five persons to serve on the Board of
Directors with staggered terms. In imple-
menting this change, all existing corporate
sponsors will be invited to become part of the
Profession components.
3. Academia—AUPHA will be invited to serve as
a Corporate Member of the Commission.
Faculties of the AUPHA member programs
and the officers of the AUPHA Board will be
the source of up to five persons to serve on the
Board of Directors with staggered terms.
Conceivably, other academically oriented
organizations could become memb ers of
CAHME (e.g., AcademyHealth, the healthcare
component of the Academy of Management).
4. At-Large Members—A number of selected
organizations will be invited to become At-
Large Members. This membership category
will ensure that a broad range of organiza-
tions characteristic of the field as a whole
will participate in CAHME. Examples of
organizations that represent disadvantaged
groups that might be considered include the
National Association of Health Services
Executives (NAHSE) and The Institute for
Diversity in Management. Yet other examples
of categories to be considered are community
health centers and long-term care organiza-
tions. Up to two seats on the Board of
Directors will be filled from the ranks of At-
Large Members. There will be an alternative
fee structure for At-Large Members.
5
D. Board of Directors and Corporate Members
The Board of Directors has the sole responsibility
for offering a membership to and admitting
a member into the corporation. The ACEHSA
Board of Commissioners and the ACEHSA Cor-
porate Sponsors have determined that the existing
ACEHSA Corporate Sponsors will handle the se-
lection of
initial members of the Board of Direc-
tors as an
interim governance mechanism.
E. CAHME Governance Composition
1. The current Board of Corporate Sponsors
and the current Board of Commissioners are
dissolved in favor of a new structure. In place
of the Corporate Sponsors, each of the four
components outlined earlier will comprise
most of the governance membership as set
forth below:
h The Market—Up t o five appointees
(practitioners or academicians)
h The Profession—Up to five appointees
(practitioners or academicians)
h Academia—Up to five appointees
(practitioners or academicians)
h At-Large Members—Up to two appoin-
tees (practitioners or academicians)
2. These appointments will t ake place in
a fashion so as to be consistent with the
U.S. Department of Education (DOE) re-
quirements and best practices of the health-
care accreditation field.
3. The CEO of the Commission will serve as
a voting member of the Board of Directors.
4. At least two persons from the general public
Inquiry/Volume 42, Winter 2005/2006
326
will be invited to serve as public voting
members by the Board of Directors. The
definition of Public Members will be drawn
from the U.S. Department of Education.
F. Roles of Board of Directors and Corporate
Members
Beyond the function of formally electing the
Board of Directors, the Corporate Members of
CAHME will have only those reserve powers re-
quired by law. The Board of Directors will gov-
ern CAHME consistent with the bylaws of the
enterprise. The Board of Directors will appoint
and serve as the reporting line for the Presi-
dent/CEO of CAHME. The Board of Directors
will make all decisions on awarding, changing,
or withdrawing accreditation based on recom-
mendations of the Accreditation Council. The
Board of Directors will set the standards of ac-
creditation taking into account recommendations
of the Standards Council. The Board of Directors
will oversee the business affairs of CAHME.
Among other fiduciary functions and accredita-
tion decisions, the Board of Directors will also
approve the competencies that underlie the
standards of accreditation in health administra-
tion, based upon recommendations of the Stan-
dards Council. The Board of Directors will be
accountable to the public with appropriate influ-
ence by its public representatives (see BRTF Rec-
ommendations R4 and R15).
In addition to the governance powers of Cor-
porate Members outlined previously, CAHME
will be structured to engage Corporate Members
in the activities of the Commission. Formal and
informal means will be used to encourage inter-
ested Corporate Members to learn about and
participate in CAHME. One such example could
be membership and participation in the councils
and committees described subsequently.
G. Committees of the Board
Committees of the Board of Directors will be es-
tablished in order to facilitate carrying out the
functions of the Board. The following are com-
mittees of the Board with a brief description
of each.
1. Governance Committee: The Governance
Committee will recommend nominees to the
CAHME Board and be accountable for board
evaluation and development activities. The
Committee will solicit nominations from
Corporate Members for appointment to the
CAHME Board. The CAHME Board of
Directors will appoint the Governance Com-
mittee. It will include Board as well as non-
board members. The Governance Committee
will include at all times at least one member
from each of the Corporate Member catego-
ries except the At-Large Member category.
Specifically, the Governance Committee will
include the Chair, immediate Past Chair and
Chair-Elect, plus additional members selected
by the Board. The immediate Past Chair of
the Board will serve as Chair of the
Committee. In the event a Past Chair is not
available, the Chair of the Board will serve
as Chair of the Governance Committee.
2. Executive Committee: The Executive Commit-
tee will consist of select officers and members
of the CAHME Board of Directors. The
function of the Executive Committee will be
to provide coordination and direction between
Board meetings. It will also carry out special
functions assigned by the Board of Directors.
3. Other Committees: Other committees can be
appointed in the future to assist the Board
of Directors as needed, such as an Audit
Committee, Operations Committee, and/or
Finance Committee.
CAHME ACCREDITATION FUNCTION
A. Goal of Accreditation
This Strategic Blueprint is intended to provide an
opportunity for accreditation standards to be ex-
amined and updated in a timely fashion. It is rec-
ognized that CAHME must develop accreditation
processes that are more efficient and less oner-
ous. Additionally, it must provide for effective
use of electronic technology that is currently
available. In addition, it must address important
questions facing the field of healthcare manage-
ment education.
The scope of accreditation must be considered
by CAHME. The historic educational focus of
most programs accredited by ACEHSA has been
management of health services delivery with
health policy an additional focus of some pro-
grams. Recently, the number of programs
emphasizing careers in the healthcare supply
Health Care Management Education
327
chain, manufacture or distribution of healthcare
products and services, and management consul-
tation has increased. Large and historically
prominent programs have designed curriculum,
faculty, and other learning resources to develop
graduate programs designed for this expand-
ing market.
These developments and others require specific
attention be paid to defining the scope of health-
care management practice that will be the basis
for accreditation. Moreover, adaptation in the
scope of accreditation is important if the Com-
mission is to avoid the experience of other fields
where accreditation has become competitive and
fragmented. While the Commission must be cog-
nizant of recent developments in the field, the
transformed Commission must define and focus
on the core competencies of healthcare manage-
ment. The Commission will identify a set of core
healthcare management competencies that all
program graduates are expected to master, while
at the same time respect diversity among the pro-
grams in terms of their educational mission, tar-
get markets, and priorities that allow extension
beyond the core.
CAHME will give careful consideration to the
ongoing work of numerous professional socie-
ties and national organizations in identifying
the core competencies. Competencies will be re-
viewed and revised on an ongoing basis as expe-
rience is gained with the use of competencies and
as new evidence becomes available.
The council structure provides a means for as-
sessment and deliberation of accreditation rec-
ommendations by professionals who will be
able to devote focused time on specific compo-
nents of accreditation. While decisions concern-
ing accreditation and accreditation standards
are ultimately the responsibility of the Board of
Directors, the advice and recommendations of
the councils are a critical component of the deci-
sion-making process.
The goal of CAHME will be to establish ‘‘lead-
ing edge’’ standards and assessment mechanisms
of quality at selected academic levels (degree-
granting programs) of the healthcare sector.
The term, ‘‘selected academic levels,’’ is meant to
apply to consideration of degree-granting pro-
grams/departments/schools at the undergradu-
ate, master’s and professional doctoral levels.
The Board of Directors will determine the levels
to be included and will commission special study
groups as appropriate. Consideration may also
be given to accrediting pre-master’s and post-
master’s residency and fellowship programs.
This goal is to assure the highest quality
educational product across the field. While contin-
uously improving quality of the strongest programs,
CAHME will enhance the quality of all accredited
programs. Accreditation or re-accreditation will
be denied or withdrawn from those programs that
do not meet accreditation standards. All elements
of structural and procedural accreditation func-
tions are designed to be consistent with regula-
tions of DOE (see BRTF Recommendations R2
and R14). Also, the standards of the private agen-
cies that accredit accreditors, the Council for
Higher Education Accreditation (CHEA) and the
Association of Specialized & Professional Accred-
itors (ASPA), are carefully considered in this pro-
posal and will be met.
B. Accreditation Functions and Council
Structure
An organizational structure of councils of
CAHME will be established with consideration
given to the recommendations of the Blue Ribbon
Task Force. This reorganized structure will carry
out accreditation processes. The new councils
will develop, recommend, and, as adopted by
the Board of Directors, implement accreditation
criteria and other forms of accreditation stan-
dards. The accreditation criteria/standards will
be developed by a component of the Council
structure comprised of academicians from
AUPHA and practitioners from the Market and
the Profession. The Accreditation Council will
also assess compliance with the accreditation
criteria and make recommendations for accredi-
tation status. The Board of Directors will develop
the exact scope and definition of each council.
Formal and informal means will be employed
to encourage constituents of CAHME to serve
on the various councils and committees.
Membership on the CAHME councils and
committees will be open to individuals not other-
wise affiliated with CAHME. The Board of Direc-
tors will determine the need for additional
councils or committees and the membership of
all councils or committees.
1. Accreditation Council—Persons will be ap-
pointed to this Council by the Board of
Directors and will be designated as Commis-
Inquiry/Volume 42, Winter 2005/2006
328
Figure 1. CAHME corporate structure
Health Care Management Education
329
sioners. One member of the Board of
Directors will serve as Chair of the Council.
The Board of Directors will appoint Commis-
sioners (academicians, practitioners, and
public members), drawing from members of
the Board of Directors, Corporate Members
of CAHME who are not members of the
Board of Directors, and others. The Board of
Directors will ensure that the Commissioners
comprising the Accreditation Council are in
equal proportions academicians and practi-
tioners.
The role of the Accreditation Council will
be to oversee the accreditation process and to
make recommendations to the Board on
individual accreditation decisions. The Ac-
creditation Council will also make decisions
relative to accreditation matters as delegated
to it by the Board of Directors. A logical
source for initial membership and leadership
of the Accreditation Council is the member-
ship and leadership of the Commissioners.
2. Standards Council—This council will have
composition and leadership formulated in
a manner similar to that of the Accreditation
Council. The Board of Directors will appoint
members of the Standards Council. CAHME
will consider qualifications of members as it
appoints members of the Standards Council
to assure sufficient over lap with cu rrent
developments in the Accreditation Council.
The role of the Standards Council will be to
maintain and continuously improve the
accreditation standards, and to recommend
standards for consideration and action by the
Board of Directors (see BRTF recommenda-
tions R8 and R13).
3. Other Councils and Committees—Other
councils will be established as needed. For
example, a council on CAHME Fellowships
could be established. Factors to be consid-
ered before establishing councils will be the
ability to secure financial support required
to create these bodies, provision of adequate
staff support, reimbursement of members
for travel expenses related to meetings, and
funding telephone conference calls. Work of
the councils/committees will be done elec-
tronically, but each body will meet at least
annually, and the Accreditation Council will
probably meet more often.
C. Accreditation Decisions
The Board of Directors, and only that entity, will
make decisions for accreditation of selected lev-
els of degree-granting university programs in
healthcare management, except as delegated to
the Accreditation Council. As a modus operandi
the Board of Directors will act on recommenda-
tions of the Accreditation Council. The Board
may decide to delegate selected actions to the
Council as appropriate.
D. Expanded Model for Accreditation—
Definition and Terms of Accreditation Levels
The change needed in healthcare leadership and
the new vision for ACEHSA make it imperative
that accreditation actions taken by the Board of
Directors (on accreditation recommendations
from the Accreditation Council) go beyond the
current choices of either Accredited or Not Ac-
credited. While the specific expanded accredita-
tion options desirable for addressing the new
vision will be considered and adopted by
CAHME, strong consideration will be given to
the following three possible options and to means
for enhancing continuous quality improvement
(see BRTF Recommendation R13):
1. Accreditation
h This credential is awarded to those
programs that meet all of the criteria for
accreditation.
h An accreditation site visit will be con-
ducted once every five to eight years, as
determined by the Commission. An earlier
site visit may be required by the Commis-
sion if there is material change in the
program, indicators of complacency in the
program, or as the result of a desk audit.
h An accreditation desk audit will be con-
ducted at the end of three years, along
with regular review of the annual reports
currently required (keyed to BRTF Rec-
ommendation R10).
2. Accreditation with Probationary Status
h This credential is assigned to those
programs that meet accreditation criteria
but in such a marginal way as to call for
early corrective action. This probationary
status carries with it requirements for
specific action by the university program.
Inquiry/Volume 42, Winter 2005/2006
330
Unless compliance is achieved within 12
months, accreditation will be withdrawn.
h The program must satisfy CAHME of
having corrected the conditions upon
which the probationary status was as-
signed, prior to the end of the 12 months.
3. Withdrawal or Denial of Accreditation
h The Commission takes this action when
programs are determined not to meet the
accreditation criteria of the Commission.
The Commission either before or after
a probationary period can withdraw or
deny accreditation.
h A program that has had its accreditation
withdrawn or denied may appeal such
a decision by the Commission consistent
with the policies and procedures of the
Commission.
h If it does not appeal the decision by the
Commission, a program may pursue ac-
creditation through the Candidacy Pro-
gram, or, if it was previously accredited, the
program has two options. One is to pursue
re-accreditation through the Candidacy
Program; the second is to petition the Com-
mission for a new accreditation process at
a later time, again consistent with the
policies and procedures of the Commission.
4. Other Means for Continuous Quality
Improvement
h In addition to the foregoing three options,
the Commission will carefully consider
creative, effective means for continually
elevating improved performance by health-
care management education programs.
E. Other Accreditation Factors
Other factors of accreditation site visits and pro-
cesses will also need to be strengthened
and adopted by CAHME. The following are
recommended:
1. Site visits will be required of all new
programs that are established by currently
accredited programs or departments.
2. The entire accreditation process, including
self-studies, conduct of the site visit, and
decision processes, will be streamlined and
made more efficient. This will be accom-
plished via a CAHME-appointed task force,
in collaboration with the Standards Council,
and will incorporate not only the best
practices of other accrediting bodies but also
create leading-edge programs and processes
(see BRTF Recommendations R10 and
R11).
F. CAHME Fellows Program
1. Purpose—The primary purpose of the
CAHME Fellows Program will be to develop
leaders in education and practice over
lifelong careers. A valuable byproduct is
provision of quality services by CAHME
Fellows to the ongoing processes.
2. Program—CAHME Fellows will serve as
integral personnel in accomplishing the
accreditation processes, conducting various
research and analytical projects, and engag-
ing in other career development experiences
that also serve the mission of CAHME. In
consideration of the service provided by the
Fellows, and consistent with its commitment
to career enhancement, CAHME will provide
attractive opportunities along several lines
for career developmental experiences by
the Fellows.
3. Requisite Resources for the Fellows Program
—The financial requirements necessary to
fulfill the purpose of the CAHME Fellows
Program as stated previously will be met
through the additional resources described in
the next section.
FINANCE AND MEMBER BENEFITS
This section outlines the means by which
CAHME will become financially strong and
will sustain its financial strength. Importantly,
it also addresses the benefits to corporate mem-
bers whose continuing support is crucial to the
achievement of the transformational objectives.
A. General
1. App roximately one-thi rd of the CAHME
operating budget will be drawn from the
Market.
2. App roximately one-thi rd of the CAHME
operating budget will be drawn from the
Profession.
Health Care Management Education
331
3. Approximately one-third of the operat ing
budget will be derived from Academia,
taking into account the annual corporate
member fee of $20K paid by AUPHA, along
with several means of financial support and
in-kind support provided by the AUPHA and
its accredited-program members, including
fees. The accreditation site visits and desk
audits will be priced so that, at a minimum,
the fees paid by the programs that participate
in the accrediting processes cover the direct
costs of these functions.
4. The Board of Directors will determine the
nature of the fee structure for At-Large
Members. It is intended that a marginal
supplement of augmenting resources will
derive from At-Large Members.
B. Funding/Budget Base
1. The Market
The financial objective of the Market is to
achieve approximately 15 members of
CAHME from the Market. Each member will
contribute $20K per year as a membership
fee of CAHME.
6
This will yield annual
revenues of approximately $300K.
2. The Profession
The financial objective of the Profession is to
achieve approximately 15 members from the
Profession . Each member will contribute
$20K per year as a membership fee of
CAHME. This will yield annual revenues of
approximately $300K.
3. Academia
The financial objective relative to Academia
is to generate financial benefit at a level
comparable to that of the Market and the
Profession. AUPHA will serve as an initial
organizational base for membership in the
Commission by Academia. As a Corporate
Member, AUPHA will contribute the annual
Corporate Member fee each year. As noted
previously, Academia also will contribute to
support of the Commission through payment
of fees for the site visits and desk audits that
cover the direct costs of these accreditation
processes, along with the in-kind support
of AUPHA.
4. At-Large Members
There will be a category of organizations that
qualify for an alternative fee structure to be
determined by the Board of Directors. There
may be some marginal contribution to
financial strength; however, the purpose of
this category is to include the important
elements of the field that characteristically
lack sufficient funds to participate in volun-
tary efforts. In addition to the examples
previously identified, others that might be
considered include: the National Association
of Public Hospitals, Community Health
Centers, the Veterans Health Administration,
the National Association of Health Services
Executives, the Institute for Diversity in
Management, the Indian Hea lth Service,
and the U. S. Department of Defense.
5. Fed eral Government Suppo rt (see BRTF
Recommendation R17)
Given national and international pressures
for critical improvements in the health
industry, this is an ideal time for a new
federal grant program to support health
services administration education. Funds
could be provided for carefully targe ted
purposes such as defining competencies,
improv ing curriculum content, developing
new pedagogy, and evaluating outcomes in
areas suc h a s in for mation al technology,
developing clinical and organizational per-
formance measurement, and promoting clin-
ical improvements through evidence-based
healthcare. There are indications within the
federal establishment of support and state of
readiness to consider such a grant program.
6. Philanthropic Support
In addition to the core support of CAHME
members, there could be substantial potential
support by individuals and organizations
with abiding concern for enhanced quality
of education and practice in healthcare
management. The correct timing and skillful
approach to such individuals and organiza-
tions could yield major resources to CAHME
toward an unprecedented margin of excel-
lence. This philanthropic support could also
provide resources for the CAHME Fellows
program as well as other components and
projects of CAHME.
C. Benefits to Corporate Members
u Identification of Benefits—The most impor-
Inquiry/Volume 42, Winter 2005/2006
332
tant consideration in identification of mem-
ber benefits is to ‘‘ask the customer’’ (see
BRTF Recommendations R15 and R16).
Some market testing has already been fruit-
ful, but more must be done. What follows are
ideas that serve to stimulate discussion.
These ideas have received mixed reviews to
date, and continue to be a component of this
strategic blueprint on a highly contingent
basis—to be confirmed or set aside based on
market reaction. In this context, a set of
ideas follows.
u Annual Colloquy of Corporate Members—
This invitation-only event is intended to have
major significance for the field. Key speakers
will be the knowledgeable and respected
leaders. The Annual Members Colloquy will
feature practitioner-academician work ses-
sions and seminars on topical issues.
The invitees to the Colloquy will be CEOs
of the organizational members of the Market
and the Profession and senior educational
leaders of Academia. A goal of this Annual
Colloquy will be to create a nexus of
relationships among leaders of the three
major components of the field. Key speakers
and resource persons will enhance the value
of the Annual Colloquy to attendees. A major
benefit to, and motivation for, Corporate
Members to attend the Annual Colloquy will
be the opportunity to interact with leaders in
other major components of the field around
a shared interest.
u Career Services—CAHME, along with pro-
grams earning accreditation with best prac-
tices acknowledgment, would implement
career services for the benefit of all stake-
holders. This could be done in conjunction
with the Annual Members Colloquy as well
as individual career days on campuses
accorded the status of accreditation with
best practices acknowledgment. The goal of
these career days could be to facilitate
recruitment and placement of the best
candidates for fill ing posit ions wit h the
members of the Market, members of the
Profession, and members of Academia.
u Work Force Needs—In return for support of
CAHME, Corporate Member organizations
could benefit through encouragement by
CAHME that accredited programs collabo-
rate directly with employers of choice in
placing the best-qualified graduates. A re-
quirement for citation as accredited with best
practices acknowled gment could be that
a program conducts annual career services
that brings students and prospective employ-
ers together. CAHME could serve as a re-
sou rce for organizi ng and administering
this process.
u Organized Collegial Contact—It may be that
the greatest reason for an organization to
become a CAHME Corporate Member is to
be a part of a highly collegial, committed
circle of very well regarded enterprises and
individuals who come together around
CAHME to shape the future of healthcare
management education.
u Benefits from the CAHME Fellows Program
—Over the years, various organizations have
attested to the value of developing organiza-
tional leadership and management skills by
those who have served as ACEHSA Fellows.
The new CAHME Fellows Program will
build upon and add value to Corporate
Member organizations through heightened
performance by CAHME Fellows.
CONCLUSION
The provisions outlined in this paper are de-
signed to achieve the objectives identified jointly
by the Corporate Sponsors and members of the
Board of Commissioners. The ideas in this paper
are supportive of the recommendations from the
BRTF and provide means for realizing the vision
of the BRTF. Not all recommendations of the
BRTF are addressed in this paper as some are re-
lated to, but not central to, the thrust of this pa-
per. The Board of Commissioners and its
successor organization, the CAHME Accredita-
tion Council, is addressing those BRTF recom-
mendations not specifically addressed herein.
The product of this Joint Task Group work cen-
ters upon a coherent strategic blueprint for the fu-
ture of accreditation in healthcare management.
The vision and goals of CAHME will best be met
by adoption of the basic principles that formulate
the strategic blueprint and enable moving on to ac-
complish the next steps toward implementation.
This strategic blueprint is a bold vision for the
future with an aggressive plan to strengthen sub-
stantially the accreditation function of healthcare
Health Care Management Education
333
management education. ACEHSA and its legion
of volunteers, supporters, Commissioners and
Fellows have served the field very well for over
40 years. The rapid pace of change, the pressures
of the times and the challenges of the future
make corporate restructuring imperative. Time
is short, much is to be done, the needs are com-
pelling, and the moment is now.
Notes
1 Inquiry’s style generally is to use two words for
‘‘health care’’; however, this document, which is
printed as adopted by the ACEHSA, uses ‘‘health-
care’’ as one word.
2 JTG membership, with affiliations at the time the
group convened, was as follows:
Howard Berman, M.H.A.
Vice Chairman
The Lifetime Healthcare Companies
Richard L. Clarke, M.B.A., F.H.F.M.A.
President & CEO
Healthcare Financial Management Association
Jeptha W. Dalston, Ph.D., F.A.C.H.E.
President & CEO
AUPHA and ACEHSA
Thomas Dolan, Ph.D., F.A.C.H.E
President
American College of Healthcare Executives
William F. Jessee, M.D., F.A.C.M.P.E.
President & CEO
American College of Medical Practice Executives
S. Robert Hernandez, Dr. P.H.
Professor
Department of Health Services Administration
University of Alabama at Birmingham
Peggy Leatt, Ph.D.
Chair
Department of Health Policy and Administration
University of North Carolina at Chapel Hill
Lawrence D. Prybil, Ph.D., F.A.C.H.E.
Associate Dean and Professor
College of Public Health
University of Iowa
Catherine J. Robbins, M.B.A., F.H.F.M.A.
Vice President
Cain Brothers
ACEHSA Fellow Analysts were:
Kanak Gautam, Ph.D.
Associate Professor of Health Administration
School of Public Health
St. Louis University
Jo¨rg Westermann, Ph.D.
Assistant Professor, Department of Health Manage-
ment and Policy, and
Director, Continuing Education Center for Public
Health Practice
University of Iowa
ACEHSA staff officers were: Lydia M. Reed,
C.A.E., M.B.A., vice president, accreditation oper-
ations; and Pamela S. Jenness, director, accredita-
tion operations.
3 This report was a joint effort of the Accreditation
Commission on Education for Health Services Ad-
ministration and the National Center for Healthcare
Leadership (NCHL). This report was completed in
the summer of 2003. Copies are available from
CAHME, 2000 14
th
Street North, Suite 780, Arling-
ton, VA 22201-2543; website: www.cahme.org
4 These annotations are denoted by reference numbers
(R1,R2, etc.) that apply to the BRTF report. Interested
readers can find this BRTF report in the Journal of
Health Administration Education 2004 21(2), spe-
cial issue called Accreditation in Health Administra-
tion Education: A Call for Change.
5 The new CAHME Board of Directors will deter-
mine the nature of an alternative fee structure. Ex-
amples might be shared annual fees with other
similar organizations, discounted fees, or even
waived fees. For example, group medical practices
without individual resources to meet the full corpo-
rate member annual fee might join through shared
arrangements to achieve presence in the new
CAHME structure. Also, such at-large members
could be a consortium of safety-net delivery organ-
izations with a mission oriented to the underserved
and the uninsured. For instance, members of the Na-
tional Association of Public Hospitals are possible
examples. Other at-large members might be organ-
izations advancing the interests of disadvantaged
groups, which thus advance the interests of the field
as a whole.
6 Members of the Market and the Profession will be
invited to commit to contributions at the level indi-
cated for two years. During these two years, the new
CAHME will demonstrate seriousness of purpose
and ability to ‘‘get the job done.’’ The first year will
be devoted to ‘‘process,’’ but the second year will
have to yield results in order to inspire confidence
of members to continue their support and participa-
tion. Following the first two years of CAHME im-
plementation, the level of annual membership fee
($20K per year) will be assessed annually by the
Board of Directors.
Inquiry/Volume 42, Winter 2005/2006
334
Access to this full-text is provided by SAGE Publications Inc.
Content available from INQUIRY: The Journal of Health Care Organization, Provision, and Financing
This content is subject to copyright.
