In the beginnings of CCAHS Don had an idea that the Health Perspectives had to be supplemented by another publication to increase and maintain projected subscriptions; a main source of revenue. After internal consideration and debate the “Quarterly” was born. The first issue entitled Hospital Accreditation And The Role Of The Consumer was published in the Fall, 1973.

The 1963 Medicare Act required hospitals to be accredited in order to participate. Accreditation could be obtained through inspection by a state agency designated to perform inspections, evaluations and licensure of hospitals or by the Joint Commission on the Accreditation of Hospitals (known then as the JCAH). State government agency accreditation was uneven across the nation and often inefficient. JCAH accreditation was uniform across the country and most hospitals were already JCAH accredited. Both had legal or contractual limitations regarding disclosure of anything related to their inspections and findings. The theory was that in order for hospitals to open their doors for inspection, privacy of specific patient data and confidentiality of any findings and remedies had to be maintained.

Accreditation was the password to participate and participation meant Medicare (and Medicaid) payment for services. But accreditation was a closed system that excluded the public and in many cases public agencies and elected representatives from obtaining necessary information to determine if the public’s money was being wisely spent.

Ed Gluckmann came across a little known procedural requirement which made it possible for consumers to participate in accreditation of hospitals by the JCAH. It gave a small voice in that process but led to some interesting reactions by hospitals, JCAH, New York State, the federal government and the media. Don Rubin sensing a method to force change and to put teeth into accreditation by involving consumers led CCAHS into a series of reports about the interrelationship of private organizations and government agencies to accredit hospitals so they could participate in Medicare as providers eligible for payment for Medicare enrollees. The first Quarterly publications caused quite a stir within the hospital community, federal and state government, JCAH and national and local news media. It all started with the first issue in the Fall of 1973.