Phase 3: URAC publishes unblinded public reports on
its website.
Organizations are required to begin reporting measures after they are accredited by URAC. An organization’s first measurement period is the calendar year after it receives accreditation, and the measures are due to URAC by April 30th of the following year.
For example, if a PBM is accredited in 2010, it
will report measures on calendar year 2011 to URAC
by April 30, 2012. PBMs and DTMs will be able to
enter their performance data through URAC’s webbased AccreditNet platform. URAC will review an
accredited organization’s |
measurement reports as a component of ongoing monitoring and of re-accreditation. URAC collects aggregate data that includes all of the organization’s eligible program participants for each measure. However, to foster transparency and dialog between organizations and their clients, URAC strongly encourages organizations to provide each of their group purchasers with client-specific rates as well, so that clients can compare the results for their participants with the organization’s aggregate results.
URAC’s measures were developed and refined with input from key stakeholders in the PBM and DTM industries. The table below provides a summary of each measure. |
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| Measure 1 |
Medication Possession Ratios (Consumer Engagement)
Medication possession ratios serve as a proxy for patient adherence to medication regimens. Using prescription claims data, organizations, in conjunction with prescribers and pharmacists, can help patients improve their medication adherence which may lead to better health-related outcomes. |
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| Measure 2 |
Generic Dispensing Rates (Cost Effectiveness—PBM Only)
Generic medications offer consumers a less expensive alternative, which may help improve patient adherence. Using prescription claims data, organizations, in conjunction with prescribers and pharmacists, can help guide consumers to safe and effective generic alternatives. |
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| Measure 3 |
Complaint Response Timeliness (Consumer Experience)
Even with the best organizations, consumer dissatisfaction can occur. Timely response to complaints by the organization improves consumers’ and clients’ experience. |
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| Measure 3 |
Overall Consumer Satisfaction (Consumer Satisfaction—DTM Only)
Measuring and reporting consumer satisfaction rates lets organizations improve the services they offer existing consumers and demonstrate value to potential clients. |
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| Measure 4 |
Call Center Performance (Consumer Experience)
Organizations provide a full range of telephonic services to consumers and providers. An efficient, responsive call center enhances the consumer and client experience. |
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| Measure 5 |
Overall Client Satisfaction (Client Satisfaction)
Measuring and reporting client satisfaction rates lets organizations improve the services they offer existing clients and demonstrate value to potential clients. |
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| Measure 6 |
Therapeutic Outcomes (Clinical Outcomes—DTM Only)
For each condition they manage, DTMs are asked to report to URAC the key outcome measures they use to assess program effectiveness, and the rationale and methodology for each outcome measure. |
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| URAC has just released for public comment performance measures for its Specialty Pharmacy and Mail Service Pharmacy accreditation products. |
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