URAC is in the process of revising three accreditation programs in its Pharmacy Quality Management® suite of products: (1) Mail Service Pharmacy (2) Specialty Pharmacy and (3) Workers’ Comp PBM. These are the first revisions of the Mail Service and Specialty Pharmacy standards to include proposed performance measures, such as dispensing accuracy, medication possession ratios, generic dispensing rates, prescription turnaround time, and overall consumer satisfaction. The measures are specifically designed to collect data on Mail Service and Specialty Pharmacy processes and outcomes considered critical for the evolution of professional practices in these areas.
    The revised programs were developed by URAC’s Pharmacy Accreditation Advisory Group and Performance Measures Focus Groups. These groups are comprised of a wide range of stakeholders including employers, consumers, pharmacy consultants, health plans, independent retail pharmacies, pharmacy benefit management organizations, pharmacy professional organizations, labor organizations, and large public purchasing groups. As part of the standards revision and measures development processes, URAC continues to enhance its programs following the principles promoted by the U.S. Department of Health and Human Services “Four Cornerstones” for health care improvement and value-based purchasing concepts. Specifically, URAC added new standards to the pharmacy programs, since information and education are key to empowering consumers.
    URAC is committed to having the broadest possible input into its standards development process. URAC strives to ensure that its accreditation is meaningful across the health care spectrum, including consumers, purchasers, providers, regulators, and the industry. Therefore, the proposed modifications were available for public comment on any section of the pharmacy standards and measures from February 5 through March 23, 2010.
    The proposed revised Mail Service Pharmacy, Specialty Pharmacy and Workers’ Comp PBM v2.0 accreditation guides include PHARM Core v3.0 and other pharmacy modules. The new standards and measures include:

New Standards:

PHARM Core v3.0
Note: PHARM Core v3.0 is the same module in the PBM and Drug Therapy Management (DTM) v2.0 accreditation programs. There were no new standards added to PHARM Core v3.0 since approval by URAC’s Board in July 2009.

• Emergency management and business continuity
• Employment background screening
• Client satisfaction
• Information confidentiality and security
  
• Coordination with external entities
  
• Consumer rights and responsibilities
  
• Employment background screening
  

Mail Service Pharmacy, Specialty Pharmacy
and Workers’ Comp PBM

• Integration and coordination with existing benefits
• Communication process

• Electronic prescribing (e-prescribing)

Specialty Pharmacy—Patient Management
Module

• Patient management periodic reassessment process
  
• At-risk patient identification and recruitment
• Periodic consumer reassessment process
• Evidence-based research and practices—Promote
  goals established for consumers, including health
  outcomes
• Customize education materials and counseling
• Information regarding other resources and providers
• Program evaluation process and outcomes (3 standards)

New Performance Measures:
Newly proposed performance measures are being considered for the first revisions of the Mail Service and Specialty Pharmacy standards as part of the accreditation. The measures are designed to collect data on Mail Service and Specialty Pharmacy processes and outcomes considered critical for the evolution of professional practices in these areas.
    To date, each measurement effort has identified a conceptual framework of measurement domains. The pharmacy measurement conceptual domains include: