Washington, D.C.– June 17, 2009 – Clear standards are essential to ensure the quality of wellness programs, health plans and health networks, according to URAC, the leading health care accreditation and education organization. URAC Director of Accreditation Valerie Nosek, RN, MPA, CPHQ, discussed accreditation standards for health plans and health networks and wellness programs at the recent America’s Health Insurance Plans (AHIP) Institute 2009.

“URAC accreditation provides organizations with external oversight, national benchmarks, public accountability and a comprehensive assessment of all aspects of their services,” said Alan P. Spielman, president and CEO of URAC. “Accreditation also allows purchasers and consumers an assurance of quality.”

Currently, 39 states, the District of Columbia and the federal government have recognized URAC’s accreditation standards as the industry benchmark. Many states require URAC accreditation to meet state regulatory requirements. The Centers for Medicare and Medicaid also recognize URAC accreditation for the Medicare Advantage Program.

To date, more than 30 companies have received, or are in process for, URAC Health Plan accreditation including Blue Cross Blue Shield of Oklahoma, Johns Hopkins Health Care LLC, and Coventry of Georgia. Approximately 120 million Americans are currently covered by URAC-accredited health plans.

URAC Health Plan standards assess the structure and process of health plans. The recently updated accreditation standards now include key quality benchmarks for five areas, including:

• Network Management;
• Credentialing;
• Consumer Protection;
• Utilization Management; and
• Quality Management.

As more focus is placed on disease prevention, wellness programs are also gaining importance. More than 12 companies have received, or are in process for, URAC Comprehensive Wellness accreditation including Innovative Wellness Solutions, LLC, Healthyroads, Inc., Health Management Corporation, Regence Blue Shield, and the Carewise Personal Wellness program from SHPS Health Management Solutions, Inc

URAC Comprehensive Wellness Standards and Measures provide a thorough evaluation of wellness programs, including assessment of transparency by measuring aspects of the program such as projected clinical and health-related benefits, outcomes reporting including both financial outcomes and health-related outcomes, and methodology disclosure.

“We are always evaluating our standards to ensure that we are keeping up with the rapidly changing health care industry,” said Ms. Nosek. “In addition the health plan accreditation, we want the AHIP members to know about our expanded comprehensive wellness program accreditation. Studies have shown that instituting wellness programs can help companies save money on insurance costs, while also helping to improve employee health and happiness.”

About URAC
URAC, an independent, nonprofit organization, is well known as a leader in promoting health care quality through its accreditation and education programs.  URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability.  Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.  For more information, visit www.urac.org.