URAC Enhances Pharmacy Accreditation with Standards Revision

| URAC Staff
male pharmacist taking notes on clipboard in pharmacy

Recognizing the ever-increasing emphasis on quality in specialty and mail order pharmacy operations demanded by today’s market, URAC just unveiled significantly revised and honed accreditation standards designed to advance performance across the industry. It’s the first major revision of the standards since 2015, says Heather Bonome, PharmD, director of pharmacy at URAC.

“There’s been a growth in interest in accreditation” in both pharmacy sectors, Bonome said during a webinar sponsored by URAC on October 1. “Payers and manufacturers have recognized the value of accreditation and often require it for network participation or access to limited distribution drugs,” she added. More than 450 organizations have achieved URAC Specialty Pharmacy Accreditation (SPP) and more than 65 organizations have achieved URAC Mail Service Pharmacy accreditation (MSP).

Describing the “major revisions” in version 4.0 of the standards, Bonome outlined five key areas of improvement:

  • Update areas where the industry has advanced by focusing on new areas of best practice and innovation.
  • Streamline and clarify standard language and eliminate duplications.
  • Remove standards that are no longer relevant or valuable. 
  • Review weights applied to elements of performance and recalibrate as needed.
  • Simplify overall guide language.

“We’re looking forward to feedback from the broader industry,” Bonome said, noting that URAC had already held nearly a dozen meetings with industry experts and advisory group members throughout the revision process. URAC began initial research in February, drafted revised standards in March, heard from clients in April and May and incorporated public comments in June before the URAC Board of Directors reviewed and approved the final work in July.

“There’s been a lot of consolidation” between versions, said Jennifer Richards, PharmD, JD, CSP, pharmacy reviewer, adding there was a determined effort to address the specific performance metrics that make for a quality pharmacy. “We focused on the appropriate key standards” when constructing the new focus areas, she added.

Streamlining and consolidation are apparent at even a casual glance. For example, the nineteen “modules” in Version 3.1 have been whittled down to nine “focus areas”:

  • Risk management
  • Consumer protection and empowerment
  • Operations and infrastructure
  • Performance monitoring and improvement
  • Pharmacy dispensing
  • Pharmacy product handling and security
  • Patient service and communication
  • Patient management (applies to SPP only)
  • Reporting performance measures

The v4.0 standards added some new standards to ensure pharmacies are performing at the highest level of quality and service, Richards said. Two areas where new standards were incorporated into the revision include:

  • Temperature Management: requirement to qualify and test at least semi-annually, the packaging and processes for distribution of all medications.
  • Patient Management (applies to SPP only): clinical protocols and programs modules must be specific to drug and disease state and should include a process to document and track goals of therapy.

Broadly speaking, Richards noted there are no significant changes in either measures, eligibility, scoring methodology or the review process between the current and revised accreditation versions. In addition, the tiered pricing structure based on prescription claim volume remains in effect. URAC is offering a new small specialty pharmacy program pricing package for qualified organizations.

The revised programs were launched on October 1st. All new pharmacies who come to URAC to seek accreditation after this date will pursue accreditation under version 4.0. Applicants who have already signed a contract to pursue accreditation under v3.1 but have not yet submitted their application may transition from v3.1 to v4.0 at no charge.

Pharmacies that are currently accredited under v3.0 or v3.1 will be held to compliance with those standards until they are ready to pursue reaccreditation. When they start the reaccreditation process, pharmacies are expected to comply with the revised standards as of the date that they submit their application.

In addition to the on-demand archive of the Bonome and Richards October 1 webinar, URAC is conducting live workshops on November 14 and 15 to further illuminate how the new accreditation program can enhance specialty and mail order pharmacy operations.

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