Everything you need to know about measure reporting
When it’s time to submit measures, it can initially seem overwhelming. Whether this is your first time going through the process or you’ve been managing measures and reporting for your organization for years, you may have questions. We have answers!
Our standards are the policies, procedures and rules required for an organization to obtain and maintain URAC accreditation. The standards are intended to provide a base in which quality can be achieved. Our performance measures are tools used to evaluate quality and/or cost. These programs are designated by the RPT-1 (M) and RPT-2 (L) standards. Measures are reported as a numerator, denominator and rate.
Your organization is required to submit measures if the program version you were accredited under contains the Measure Reporting Standards (e.g., RPT-1 and RPT-2). URAC-accredited organizations are required to submit all mandatory measures on an annual basis at a minimum, pursuant to the RPT-1 standard indicated in the program-specific standard guides. Because this standard has a mandatory compliance rating, failure to submit mandatory measures annually adversely affects an organization’s accreditation status. Per the RPT-2 standard, submitting exploratory measures are not essential to meet the reporting requirement. However, submission is strongly encouraged so that the measures can be further assessed for benefit.
Your organization is required to report measures annually, following the first measurement period.
The measurement period is the timeframe that an organization prepares their data systems and collects data, typically a calendar year.
Your organization’s first measurement period is the calendar year following the year in which it received URAC accreditation. You’ll be required to report the measures the next calendar year. So, if your organization is accredited in 2023, your first measurement period is 2024, and your reporting year is 2025.
The reporting year is the year following the measurement period, when organizations report the measures values collected during the measurement period.
No. URAC uses a web-based measures tool where organizations can submit their annual measure data.
URAC provides organizations with access to the URAC measures tool for submission of measures information. Prior to the measure submission period, user credentials and a direct link to the portal are provided to each organization’s primary contact. Measures are not submitted via the AccreditNet platform.
The measures portal is open from July 1 through September 30. There will be no extensions granted to submit data after the portal closes.
Reporting instructions and templates are updated annually and available in the fourth quarter of each year. The reporting instructions and templates can be accessed through AccreditNet within the Shared documents section. You can also request this information from your Client Relations Manager or by emailing email@example.com.
Organizations with a Health Plan and/or Health Plan with Health Insurance Marketplace accreditation and Pharmacy Quality Management® programs are required to have their measurement data validated by an independent third party. Pharmacy programs began submitting validated measure data in 2016. Health plans with marketplace accreditation must follow the government guidelines for validation and submission.
URAC reviews the current list of measures on an annual basis to determine if a measure needs to be updated or retired. Updated measure specification documents will be available annually in the fourth quarter and will be applicable to the upcoming reporting period. The updated specifications can be found in the Shared documents section of AccreditNet.
The Pharmacy Information Systems Capability Assessment© (ISCA) is a form completed by accredited organizations for a program that requires data validation for measurement submission. The form is used to detail an organization’s policies, processes and data quality control procedures, and to support the data collection and reporting processes required to maintain accreditation. The Pharmacy ISCA can be found under with the Shared documents section of AccreditNet.
Yes, a fee is assessed every year for use of the portal to submit measures. This fee is evaluated on an annual basis and may change. Access to URAC’s reporting platform is contingent upon receipt of payment.
Yes. When data validation is required, an accredited organization will contract directly with an approved data validation vendor who will charge a fee for their services.
They are located on the URAC website in the Measurement Section.
No. Data Validation Vendors submit final validation reports directly to URAC. The Final Validation reports are applicable for Pharmacy Quality Management© accreditations only.
Questions can be directed to the Quality, Research & Measurement Department at URAC. They can be reached via email at: firstname.lastname@example.org, please include the following information to ensure a timely and accurate response to your inquiry,:
- Application number
- Organization name
- Accreditation program and version
- Measure number (if applicable)
No. The measures attestation form is used when completing an application, specifically for the RPT-1 and RPT-2 standards. The attestation form indicates an organization’s understanding that the program may have measures and that an organization is required to submit them, as appropriate. This document does not have to be submitted annually.