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URAC Announces Revised Case Management Accreditation Standards and Measures

Wednesday, December 17th, 2008

Washington, D.C. Dec. 17, 2008 – URAC announced today that its Board of Directors has approved revised Case Management accreditation standards. The 4.0 Case Management Accreditation standards include major revisions and new measurement requirements.

URAC, one of the nation’s leading independent accrediting organizations, sought input from a 40-member Case Management Focus group and called for public comment on two separate occasions for these significant standards revisions.  The focus group met a total of nine times to help structure and refine the standards and measures.

The revisions align with the principles put forward by the National Transitions of Care Coalition (NTOCC), an organization dedicated to improving the quality of care coordination and communication when patients are transferred from one level of care to another. URAC serves on the NTOCC’s Advisory Task Force. Although URAC’s case management standards already addressed care coordination, the revised standards elaborate significantly on the assessment process and tools available to case managers that are specific to transitions in care.

“We know that transitions of care are a critical juncture in the patient’s treatment process that require coordination and good communication between providers, patients and their family caregivers 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 revised accreditation standards and measures reflect issues currently affecting the field of case management and support the ongoing efforts of case managers to make transitions safer and to improve quality in the case management process.”

The revisions also require organizations to produce and report to URAC on a specified set of performance measures.  These measures can be used by accredited organizations for internal performance improvement and for reporting to customers, or for direct reporting to the public.  In the future, URAC’s accreditation process will include public reporting of the measures.  The measures include medical readmissions, timeliness of complaint resolution, overall consumer satisfaction, and measures for service dimensions for health care, behavioral health, and workers’ compensation case management programs.

“Measurement provides an opportunity for case management organizations to evaluate their processes and determine areas for improvement,” said Joann Richards, PhD, RN, URAC’s vice president for research and measurement.  “The mandatory measures are designed to address multiple performance domains.”
Other major changes to the standards include:

  • Promotion of evidence-based case management practices;
  • Revisions to address the full complement of medication management as an integral component of patient safety (i.e., medication knowledge, adherence and reconciliation);
  • Clarification of specific aspects of writing case management goals;
  • Expansion of the role of case review to address all levels of performance assessment;
  • Update and clarification of case management staff training and role requirements, to include training in evidence-based care plans and more specific topics for training content; and
  • Clarification of qualifications for case managers and those supervising them, as well as the role of non-case managers in the case management process.

“URAC has been a leader in case management accreditation, and these major revisions demonstrate our commitment to creating meaningful standards that will serve the industry and promote quality improvement,” said Douglas Metz, DC, chairman of URAC’s Health Standards Committee and chief health services officer for American Specialty Health. “Case management organizations are responsible for care coordination for the most complex cases.  These revised standards emphasize the need for high standards in patient safety, care transitions, and quality improvement within the discipline.”

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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.

For more information about URAC, contact us.

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