The Basics

This standard sets forth requirements for establishing goals and measuring performance for access and availability to providers.  However, our experience is that it is not written in a way so as to convey the full breadth of the requirement.  So, rather than repeat the standard here, I'll give you my version, which, I believe, more accurately captures what URAC seeks:

(a) With respect to access (i.e., geographic dispersion or travel time) of providers to provide care to consumers, the organization: 
    (i) Establishes goals; 
    (ii) Measures actual performance in comparison to those goals: and
    (iii) Makes improvements where necessary for the provider network.
(b) With respect to availability of providers to provide care to consumers (i.e., ability of consumers to receive care in a timely fashion), the organization: 
    (i) Establishes goals; 
    (ii) Measures actual performance in comparison to those goals: and
    (iii) Makes improvements where necessary for the provider network.
(c) The organization reports the measurements described above to the quality management Committee.

If you think about the standard this way, you are far less likely to make the most common NM 2 error, to submit documentation that relates only to geographic dispersion, and not the ability of consumers to receive care in a timely fashion.

Management Tips

So, what kind of documentation are we talking about here?

For “access”, since your goals will be expressed either geographically (e.g., “2 providers per specialty per county”) or drive-time (e.g., “no more than 30 minutes drive to a primary care provider in urban areas and no more than 45 minutes in rural areas”), documentation of measurement of your performance against those goals will be in the form of a GeoAccess or similar report.

On the other hand, for “availability”, since your goals will be expressed in terms of hours of availability (e.g., “office open at least 30 hours per week”) , wait times for appointments (e.g., “no more than a two week delay for a non-urgent appointment”),  or customer satisfaction regarding the ability to receive care in a timely manner (e.g., “85% customer approval of provider availability”),  documentation of measurement of your performance against those goals should include consumer surveys (like CAHPS), the results of so-called “Secret shopper” calls to your providers, and reports from your onsite visits to providers' offices.

As much as is humanly possible, however, in any event, you should strive to present performance measurement in the same units of measurement as you express your goals for both access and availability.

URAC Accreditation Tips

The three elements of this standard are weighted either 3 or 4..

For the desktop review, submit a P&P and/or program document that outlines how you establish goals and measure performance regarding access and availability.  In addition, submit one or two sample reports (or portions of sample reports) for both access and availability.

The onsite review will involve both an interview of management personnel and an examination of your full access and availability reporting.