The Basics

Under this standard, your DM program must measure and report financial outcomes for each condition on an annual basis.  Such reports may address any of a number of financial outcomes, such as overall costs, or number of service units (e.g. ER visits), or claims savings.

Management Tips

URAC wants you to show your work for this standard, so be sure your documentation shows not only what your results are, but how you arrived at those results.  Your documents should identify data sources, methodological approach, and adjustments for such factors as inflation.

URAC Accreditation Tips

This standard has a point value of 3.

For the desktop review, submit your annual report of financial outcomes.

During the onsite review, the URAC reviewer will review client-specific reports and talk with staff members about their understanding of how financial results are calculated.