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URAC Releases Revised Standards for Nine Health Care Management Accreditation Programs

Wednesday, August 13th, 2008

Changes include new health literacy standard across all health care management programs

Washington, D.C. Aug. 13, 2008 – URAC’s Board of Directors has approved comprehensive revisions to nine of the organization’s health care management accreditation programs. The changes include additions to URAC’s Core Standards that address the need for greater consumer empowerment and health care transparency. The Core Standards are foundational standards for organizational quality that are a part of all of URAC’s health care management accreditation programs.

In addition to changes to Core Accreditation, URAC’s Board approved revised standards for Independent Review Organization, Disease Management, Health Utilization Management, Workers’ Compensation Utilization Management, Health Call Center, Credentials Verification Organization, Claims Processing and Consumer Education and Support accreditation programs.

“The Core Standards help organizations define quality systems and set the framework for continuous quality improvement,” said Douglas Metz, DC, chairman of URAC’s Health Standards Committee and chief health services officer for American Specialty Health. “The new standards both advance the consumer focus in health care management and continue to raise the bar on organizational quality improvement efforts. The standards reflect significant input and recommendations from policy and corporate leaders across the health care management stakeholder spectrum.”

The new standards support consumer empowerment through an emphasis on health care literacy. The Health Standards Committee met numerous times to ensure that this and other major health care policy issues were addressed in the revised standards, and consulted focus groups that included industry experts and other stakeholders.

Information is key to empowering consumers to manage their own health care, yet it is often difficult for consumers to find in a format that is easy to understand. The introductory health literacy standard now included in URAC’s Core Standards requires organizations to:

  • Put consumer materials in plain language;
  • Assess the use of plain language in consumer documents; and
  • Provide information and guidance on health literacy to staff who write consumer materials.

In addition, URAC’s new Disease Management Standards include a requirement for accredited organizations to establish a framework that systematically provides the right information at the right time to the consumer.  The standard calls for accredited organizations to:

  • Have a plan addressing the delivery of health information to consumers;
  • Proactively provide accurate, comprehensive information that is easy to use; and
  • Evaluate consumer health information for accuracy and appropriateness for the population served.

“URAC’s new disease management information therapy standards send an important message that high-quality, chronic care management requires a patient-centered approach,” said Joshua Seidman, Ph.D, president of the not-for-profit Center for Information Therapy. “These standards set an important quality bar for disease management; for DM to work, it must be supported by the proactive delivery of information targeted to a consumer’s moment in care and tailored to his or her individual needs.”

The revised Core Standards also address issues in health care designed to promote greater efficiency in the health care system, such as support for interoperable health information technology. New standards also require the use of national quality measures, where they exist, as benchmarks for quality improvement projects.

Important clarifications were made for the Independent Review Organization Accreditation standards regarding compliance with state and federal law and credentials for clinical peer reviewers, an important aspect of ensuring the quality of independent review decisions. Standards relative to timelines were tightened to reflect current industry practice and expectations.

URAC released draft standards to the public in April, inviting the industry and interested parties to provide input. Hundreds responded, representing employer groups, consumers, providers and government entities. They weighed in with comments, clarifications and enhancements relevant to the changes occurring in health care today.
“URAC’s standards revision process relies on the active participation of industry stakeholders and an engaged public,” said Alan P. Spielman, URAC’s president and chief executive officer. “Our goal is to protect and empower consumers and to continuously raise the quality bar through accreditation and education programs. The new standards for health care management organizations support greater transparency and industry trends that are on track to improve both efficiency and overall quality.”

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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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