Case Management Accreditation

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Care coordination, transitions of care, patient engagement and advocacy are core principles for case management. URAC’s Case Management accreditation standards require companies to establish the policies, procedures and structure needed for optimal case management performance.

Our case management standards and performance measures address the increasing demand for excellence in care coordination, including improving consumer engagement, achieving optimal healthcare outcomes, and managing transitions of care. Understanding the value of integrated care, URAC also weaves key behavioral health components into our Case Management Accreditation standards.

By achieving URAC accreditation, case management programs display leadership through a commitment to quality and accountability.

The URAC-accredited case management program:

  • Provides collaborative communications between all stakeholders, including patients, family/caregivers and the healthcare team
  • Develops evidence-based, individualized patient-centric goals to achieve quality healthcare outcomes
  • Ensures that clinical and non-clinical staff have clearly defined roles and responsibilities
  • Assesses medical safety, including the need for medical therapy management services
  • Uses information support systems to achieve and measure case management performance goals
  • Achieves patient self-management goals and optimal levels of wellness through consumer education and engagement
  • Ensures safe and effective transitions of care across settings to prevent poor health outcomes

Health plans, payors, employers, and federal and state agencies, recognize URAC Case Management Accreditation as a key catalyst in advancing care coordination, quality, and overall excellence of customer-centric service.

Download our Case Management Standards-at-a-Glance and Measures-at-a-Glance

Transitions of Care Designation

Organizations that achieve the URAC Case Management Accreditation have an opportunity to obtain the URAC Transitions of Care (TOC) Designation.  TOC recognizes those organizations making safe care continuity the focus for quality improvements that will be used to reduce errors, preventable readmissions, and poor health outcomes.

The coordination of services, education and the timely transfer of information between hospitals, physicians, post-acute care providers and patients are essential components of effective transitions of care management.

By adhering to URAC’s essential set of standards and performance measures, your organization demonstrates a commitment to successfully managing the safe and timely transfer of patients from one care setting to another.

Your URAC Case Management Accreditation, plus the Transitions of Care Designation, showcases your organization’s commitment to quality and innovative care management practices that will reduce cost and increase quality.

Who May Apply

Organizations that offer a case management program, such as, hospitals, accountable care organizations, health plans, provider-based practices, clinics and more.

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