June 24, 2008
RE: Public Comment – Health Management: Comprehensive Wellness Accreditation Standards and Measures, v. 1.0
Dear Colleague:
URAC is pleased to present for your review the Draft Health Management: Comprehensive Wellness Accreditation Standards and Measures. We invite you to provide comment on the proposed standards by August 7, 2008. We hope that you take some time to review the draft standards and share your thoughts and comments with us. URAC will review all public comments with its Advisory Group and will then Beta Test the standards in late August-September 2008. URAC anticipates finalizing the standards and measures in December 2008 and announcing the first accredited companies shortly thereafter.
Recent trends in benefits management indicate that employee health and wellness is a critical focal point for health care purchasers because of its direct correlation to health care costs and internal productivity. Purchaser adoption of wellness programs has increased dramatically in recent years. The majority of these programs focus on chronic disease prevention and promotion of healthy lifestyle choices. According to the Society for Human Resource Management, approximately 86% of employers in the United States currently offer wellness programs to their employees. This surge in wellness adoption may be due to evidence suggesting that employers can achieve a positive return on investment with the adoption of a successful wellness program. URAC’s accreditation program is designed to assist purchasers in their choice of quality wellness and health promotion programs.
The draft standards and measures have been developed by an expert advisory group for wellness programs in response to employers’ requests for quality standards and measures for both comprehensive and focused wellness programs. The more than 50 advisory committee members include employers, health plans, public benefits organizations, health care professional associations, health care providers and wellness promotion companies. The group represents a variety of perspectives from the health care industry.
URAC is proposing two new accreditation programs to add to its suite of health management programs: Comprehensive Wellness Accreditation and Focused Wellness Accreditation. URAC’s Comprehensive Wellness Accreditation is slated to include five areas of focus for organizations offering services to support health promotion and risk reduction across the broad spectrum of behavioral and physical characteristics. In addition to including the Core Organizational Quality Standards, the Wellness modules are:
- Assessment: Includes risk identification and risk awareness components;
- Interventions: Addresses overall program design, staffing, and use of incentives, education and communications aspects of wellness programs;
- Evaluation: Focuses on how the wellness organization calculates, measures, and reports participant progress and overall clinical and financial program success to the purchaser;
- Integration: Focuses on an organization’s ability and willingness to coordinate with other organizations, operations, and programs already in place; and
- Measurement: Focuses on producing and reporting on a specified set of performance measures as part of internal performance improvement, reporting to purchasers and public reporting.
URAC’s Focused Wellness Accreditation includes three areas of focus for organizations offering services to support health promotion and risk reduction across a narrower spectrum of behavioral or physical characteristics. These three areas, in addition to the Core Organizational Quality Standards, are: Interventions, Evaluation, and Measurement. The standards within the Focused Wellness Accreditation are the same as the Comprehensive Wellness Accreditation.
As health care purchasers are increasingly focused on value-based purchasing of health care and health promotion services, URAC has responded in its accreditation program by offering for the first time both a quantitative performance measures component and a financial and clinical program evaluation component. These new standards and performance measures components will allow health management companies to demonstrate that they meet value-based purchasing expectations and will aid purchasers as they compare and evaluate the services those health management companies provide.
The URAC accreditation programs are designed to encapsulate a broad array of wellness organizations and programs. The standards reflect two emerging areas within the wellness and health promotion market: management of health and behavioral characteristics. Each of these wellness areas includes managing multiple and diverse risk-types, such as proper nutrition, weight management, smoking cessation, prevention of depression, stress management, and prevention of alcohol abuse. The URAC Comprehensive Wellness Accreditation is only available to those organizations that offer management of both health behavioral characteristics over several risk-types. However, it is not URAC’s intent to exclude risk-type specific organizations and programs that may only focus on health or behavioral characteristics, such as a smoking cessation program, from receiving accreditation. Therefore, focused wellness programs will be able to apply for accreditation, but under the “Focused Wellness Accreditation” heading.
URAC is on a multi-year path for developing mandatory performance measures, the following time line reflects the planned approach to this effort:
Year 1: The URAC-specified mandatory performance measures are reported on the time frequency specified and used with the focus on an organization’s internal performance improvement and oversight activities.
Year 2: Mandatory measures become subject to an external auditing/verification process and, where there are sufficient numbers of accredited programs, de-identified aggregate reports would become available to the participating organizations and interested third parties.
Year 3: Measures that have undergone an external auditing/verification process would be included in unblinded public reporting formats on the URAC website for access by consumers, employers, regulators, etc.
Another important innovation in the draft wellness standards is the promotion of evidence-based research into the selection and delivery of wellness and health promotion services. The Standards requires that services are consistent with and supported by evidence-based practices and creates a path for reporting level of evidence to purchasers and consumers.
Next to each standard element, a weight is assigned for scoring purposes and interpretive information follows each standard. You are welcome to comment on any section of the draft standards and measures. URAC receives comments through the online comment form linked to the bottom of this page. Public comments are due no later than August 7, 2008.
URAC is committed to having the broadest possible input into its standards and measures development process. We strive to ensure that our accreditation is meaningful across the health care spectrum, including consumers, purchasers, providers, regulators, and the industry. Public input is a very important part of this process. We would greatly appreciate your comments on the draft standards.
Thank you for being an important part of URAC's standards development process. Please feel free to contact us if you have any questions. For more information, please contact URAC’s Director of Standards Development, Michelle Phipps at 202.216.9010.
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