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Public Comments Requested for URAC’s Revised Case Management Accreditation Standards and Measures

Tuesday, September 2nd, 2008

Draft Version 4.0 includes input from 40-member Case Management Focus Group

Washington, D.C. Sept. 2, 2008 – URAC, one of the nation’s leading independent accrediting organizations, called for public comment today on revisions to its draft Case Management accreditation standards and proposed measures. URAC is seeking input from any interested parties, including purchasers, policy makers, consumers, health care management organizations and health plans. The deadline for public comment is Oct. 2, 2008.

URAC initially called for public comment on the revised Case Management standards in April 2008, but determined that additional input was needed to ensure that the current issues affecting the field of case management were addressed in the revised standards. A focus group of more than 40 volunteers in the field of case management was also called upon to assist the URAC Health Standards Committee in the revision process.

Among the issues addressed as part of the revision are principles relating to care transitions. URAC serves on the Advisory Task Force of the National Transitions of Care Coalition (NTOCC). NTOCC brings together thought leaders, patient advocates, and health care providers from various care settings in an effort to improve the quality of care coordination and communication when patients are transferred from one level of care to another. Revisions to URAC’s proposed Case Management standards elaborate on the assessment process and tools an organization makes available during care transitions.

Other changes to the proposed standards include promoting evidence-based case management practices, where goals established for consumers include clinical outcomes; and addressing additional patient safety issues such as medication management. The new standards also update and clarify case management and staff training to include training in evidence-based tools and care plans, as well as qualifications for case managers and case management supervisors. The role of non-case managers in the overall case management process is also addressed.

The revised case management accreditation program proposes to require organizations to produce and report to URAC on a specified set of performance measures on a periodic basis.  These measures can be used for internal organizational performance improvement and for reporting to customers or direct reporting to the public.  In the future, URAC’s accreditation process will include public reporting of these measures.  The draft measures include service dimensions for health care, behavioral health, and workers compensation, as well as consumer experience, engagement, and satisfaction.

“Transitions in care are a critical juncture in the patient’s treatment process.  They require coordination and good communication between providers to ensure patient safety and optimal care,” said Cheri Lattimer, executive director of the Case Management Society of America and NTOCC project director. “URAC’s draft standards support the ongoing efforts of case managers to make transitions safer and to improve quality in the case management process.”

The standards are available for review at https://www.urac.org/publiccomment/. URAC will only accept comments through this online comment form. After public comment, additional revisions will be made. Final draft standards and measures are expected to be reviewed by URAC’s Board of Directors in December 2008.

“URAC’s standards revision process aims to bring all stakeholders to the table to tap into industry expertise and current practice in the field.  As part of that process, we are dedicated to carefully evaluating every public comment we receive,” said Douglas Metz, DC, chairman of URAC’s Health Standards Committee and chief health services officer for American Specialty Health. “Case management addresses some of the most complicated health care management needs of patients in the health care system. URAC’s standards underscore the importance of ongoing quality improvement efforts and patient safety protocols within case management organizations.”

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For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care.

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