URAC approves core quality standards - In the News - Utilization Review Accreditation Commission - Brief Article

Healthcare Financial Management, Oct, 2001

The URAC board of directors has approved a new core accreditation program designed to ensure that healthcare organizations have in place the basic elements needed to promote quality. The new program provides a mechanism for all types of healthcare organizations to demonstrate their commitment to quality and accountability. URAC's core standards are designed to be flexible so they can adapt to a variety of organizational models. Because they are generic, the standards are not meant to provide guidance on the performance of specific health functions.

The purpose of the core standards is to address issues that are common to the range of organizations that URAC accredits and provide a framework within which quality health functions can operate. The core standards address key issues, including organizational purpose and structure; staff qualifications, training, and management; oversight of delegated activities; quality management; and consumer protection and patient safety.

Accreditation under the core standards is being offered on a stand-alone basis for organizations that do not otherwise qualify for a URAC accreditation program. URAC reviewers will determine eligibility on the basis of how a company markets itself. If the services it markets fall under any of URAC's other accreditation programs, core accreditation is not an option. Health-based companies or organizations that would be eligible for core accreditation include IPAs, pharmacy benefit managers, trade associations, not-for-profit healthcare foundations and other charitable organizations, and education vendors.

In addition to offering the core standards as a stand-alone accreditation program, URAC is building the core standards into each of its accreditation programs. Each program will contain the core standards and a module that addresses a specific healthcare function. For example, the next version of the health utilization management standards will contain the core standards and a module that addresses utilization management functions. Applicants will need to meet all of the standards to achieve health utilization management accreditation.