and communication materials for patients or their
caregivers; and e-prescribing. Each of these solutions
addresses a different aspect of medication use/
behavior continuum, and none are a “one-stop
solution.”
The problem of medication adherence and the
potential solutions are of great interest to employers,
who are mostly concerned about increased healthrelated
costs, decreased productivity and an unhealthy
workforce. Nearly nine in ten employers rate
medication adherence as an important objective in
managing employee health. The “drill-down” analyses
described above can provide some direction for the
actions that can be taken to address non-adherence.
Identifying which age-bands or conditions of the
employee population or which therapeutic classes of
medications tend to have the higher rates of nonadherence
can help employers and others better
plan which programs and tools to implement. These
initiatives may be perceived as effective; however, the
initiatives that employers are most confident about
in terms of effectiveness are those that are most
measurable.
In the most recent version of URAC standards for
Pharmacy Benefit Management accreditation (PBM |
version 2.0), Performance Measures and Reporting
Standards have been added. One of the performance
measures is Medication Possession Ratios, as a
retrospective proxy for medication adherence, and is
required to be reported for specific medication classes.
Detailed specifications for these measures are provided
to organizations applying for accreditation.
The issue of medication adherence today is growing
in importance and concern. Understanding the
problem, how it is measured and potential solutions
are all essential to ensuring that people achieve the
desired therapeutic outcomes of medication therapy.
There are more discussions and more activities that
need to happen. Consider the following readily
available tools and resources:
- www.takingmeds.com
- www.mymedschedule.com
- www.adultmeducation.com
- The World Health Organization (WHO)
- International Society for Pharmacoeconomics and
Outcomes Research (ISPOR)
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 URAC is an independent, nonprofit organization whose mission is to
promote continuous improvement in
the quality and efficiency of health care management through
the processes of accreditation and education. To support this
goal, our Board of Directors represents the full spectrum of
stakeholders interested in our health care system, including
consumers, employers, health care providers, health insurers,
purchasers, workers’ compensation carriers and regulators.
Incorporated in 1990, URAC pioneered utilization management
accreditation by creating a nationally recognized set
of standards to ensure accountability in managed care determinations
of medical necessity. As the health care industry
evolves, URAC continues to address emerging issues: we
now offer 22 accreditation and certification programs across
the health care spectrum.
Many states have found URAC accreditation standards helpful in ensuring that managed care plans and other health
care organizations are meeting quality benchmarks. Thirtyeight
states and the District of Columbia currently reference
one or more URAC accreditation programs in their statutes,
regulations, agency publications or contracts, making URAC
the most recognized national managed care accreditation
body at the state level.
At the federal level, four federal agencies recognize
URAC accreditation. The Centers for Medicare and
Medicaid Services recognize URAC Medicare Advantage
Health Plan Accreditation for the Medicare Advantage (formerly
Medicare+Choice) Program; the Office of Personnel
Management recognizes all URAC accreditation programs
under the Federal Employee Health Benefits Program;
TRICARE/Military Health System recognizes URAC’s Health
Network Accreditation; and the Department of Veterans’
Affairs recognizes URAC’s Health Call Center Accreditation. |
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