The Basics

This standard sets forth requirements for establishing goals and measuring performance for access and availability to pharmacies in your network.  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 pharmacies 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 pharmacies 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.

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 pharmacies per county”) or drive-time (e.g., “no more than 30 minutes drive to a pharmacy 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”),  or customer satisfaction regarding the ability to receive care in a timely manner (e.g., “85% customer approval of pharmacy 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 pharmacies and reports from your onsite visits to pharmacies.

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 have a weight of 4.

Documentation at the desktop review stage will involve a combination of geo-access analyses, any reports of availability and analyses (secret shopper, pharmacy visits, etc.), consumer satisfaction surveys that address access to pharmacies, etc.

The on-site review will focus on an interview with the management team for network management and any recent documentation of measurement of performance against access and availability goals.