The Basics

The standard outlines the minimum requirements for your quality management program.  URAC makes it quite clear that each one of these elements must be clearly documented:

• goals and methods used in monitoring and evaluating quality management activity;
• the identification, tracking, and trending a performance measures (including access to services, complaints, and satisfaction);
• the use of quantifiable measures to establish acceptable levels of performance;
• measurement of baseline levels of performance;
• annual re-measurement of performance;
• action plans to correct or improve performance where needed to meet performance goals;
• methods to communicate these quality activities to the relevant members of the staff;
• reporting of such activities to the quality management committee.

Management Tips

This is a new standard in which URAC takes nearly all of the components of its quality improvement project requirements and extends them to your performance measures.  Therefore, even if you haven't identified a performance measure as an area suitable for quality improvement project, you still should be measuring a performance against clear goals on a periodic basis and making corrections when you don't meet those goals.

The essential part of the standard for managers is making sure that you have a policy and procedure that clearly outlines how all of these elements are to be documented.

URAC Accreditation Tips

This standard is a mixture of mandatory elements and elements weighted 3.  

For purposes of the desktop review coming should submit your quality management program description and any associated policies and procedures that specifically address performance measurement.  In addition, you should submit one or two summary reports demonstrating implementation of those policies and procedures, as well as a sample action plan.

During the on-site review, the reviewer will examine your full complement of performance evaluation reports.  In addition, he/she will look at evidence of how you've communicated those results to appropriate staff members.  Finally, the reviewer will interview program management staff members about two in activities with which they are involved.