In recent years, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has expanded its traditional role as a leading evaluator of health care organizations to incorporate new attitudes and strategies in the areas of quality and performance improvement. This paper outlines plans for modifying the current accreditation process, and includes a proposition that accredited organizations actively participate in a quality measurement system and become involved in the process of selecting appropriate measures. The paper presents current and proposed methods for measuring performance standards, compares major accreditation systems, and explores the public's expectations for health care quality and the JCAHO's role in quality improvement and cost containment.