- Medication possession ratios (Mail Service and
Specialty)
- Medication possession ratios for hepatitis C
(Specialty only)
- Generic dispensing rates (Mail Service only)
- Complaint response timeliness (Mail Service and
Specialty)
- Call center performance (Mail Service and Specialty)
- Overall consumer satisfaction (Mail Service and
Specialty)
- Overall client satisfaction (Mail Service and Specialty)
- Prescription turnaround time (Mail Service and Specialty)
- Dispensing accuracy (Mail Service and Specialty)
- Distribution accuracy (Mail Service and Specialty)
The release of these measures continues the work
URAC began in 2008 with the inclusion of measures in its PBM and DTM programs in 2009.
URAC has worked and will continue to work with
other organizations to avoid redundancy and increased reporting burden whenever possible. |
One of the particular challenges to measurement work in the pharmacy
area concerns the unit of analysis.
Much of the work in pharmacy performance measurement
has been done at the prescriber, pharmacist
and retail pharmacy levels; not at the Mail Service and
Specialty Pharmacy levels. Furthermore, a number of
existing pharmacy measures are not accessible in the
public domain for adoption into regulatory, accreditation,
pay-for-performance or other purposes. Where
URAC was able to access and consider other organizations’
measure development work, the URAC measure
specifications acknowledge the sources that informed
the development of particular measures. The specifications
also identify other organizations that have developed
content that may be of interest to readers.
In our accreditation programs, URAC always
strives to recognize and further the health care quality
enhancement work of consensus driven organizations.
This is particularly important to us in our measure
development work. URAC thanks the DMAA: The
Care Continuum Alliance and the Pharmacy Quality
Alliance (PQA) for their support and encouragement in
the development of measures that are conceptually consistent
with their efforts. |
|
 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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