How We Select and Develop Measures

Measures selection is a continuous process at URAC. The selection process includes an environmental scan, literature review, public comment, focus groups, expert opinions, and reviews by URAC Advisory Groups and Committees. Selected measures align with URAC’s Quality Domains.

With our priority of consumer protection and empowerment, our measurement efforts focus on outcome measures, composite measures and flexibility of measures collection.

Certain URAC accreditation programs require ongoing monitoring and reporting of quality measures. If needed, your first measurement period is the calendar year following the year your program became URAC-accredited.

Performance Measures Process

Health plan and pharmacy accreditation programs require validation of measures data prior to submission to URAC. Validation ensures data accuracy and enables reporting to draw reliable comparisons between organizations.

  1. Review of reporting instructions
    • Published in Q4 every year
    • Review as soon as possible so you can prepare your systems to collect performance measurement data for your first reporting period
  2. Measures collection (Year 2)
    • Starting January 1, collect the data required for your accreditation program
  3. Data validation (Year 3)
    • Depending on your program, collected data may need independent validation by a URAC-approved data validation vendor prior to submission
    • Validation must be done in the same year the data is expected to be reported
  4. Measures submission (Year 3)
    • Submit your data (from the previous calendar year) during the measures submission period of July 1-September 30
    • Measures submission is required every year your organization maintains accreditation

Health plan and pharmacy accreditation programs require validation of measures data prior to submission to URAC. Validation ensures data accuracy and enables reporting to draw reliable comparisons between organizations.

Measures Reporting Timeframe

Measures selection and development is a continuous process at URAC. The calendar year following the year that your program becomes URAC accredited is your first measurement period. You’ll collect measurement data for the year. The reporting period for that data begins the next calendar year on July 1 and ends on September 30. You’ll be required to report measures values during this period. Then, each year after the third year, you will be required to report measures values from the data you collected the previous year.

URAC Measurement Timeline

About Measures

Measurement FAQs

Research and Measurement Reports

Data Validation Process

For this step, your organization selects an independent URAC-approved data validation vendor. We suggest having your contract in place by March 31 of your reporting year(s) to be ready for the measures submission time period.

  1. Pharmacy Information Systems Capability Assessment© (ISCA)
    • Provide details on organizational policies, processes and data quality procedures
  2. Source code review
    • Validates all programs, logs or reference tables used for measures reporting
  3. Rate review
    • Confirms accuracy of each measure
  4. Site visit
    • Assesses operational areas and reported processes
    • Organization needs to investigate and correct any identified issues prior to measures submission
  5. Final validation report
    • Summary of all findings and final approved measures data

URAC Approved Data Validation Services

Health plan and pharmacy accreditation programs are required to have measures data validated prior to submission. You will submit your measures data to URAC through a secure, web-based survey platform.

Data validation services are currently being offered by six URAC-approved vendors. Click here to download information on these vendors in PDF format.

URAC Pharmacy clients may select and contract with any of the URAC-approved data validation vendors. Direct links to each of their websites are available by clicking on the vendor names below:

Hear from each of the validators directly in the video below: