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New URAC Issue Brief Answers Questions About Delegated Credentialing, Transparency in Physician Tiering Programs
Date:6/17/2008

redentialing is among the top administrative functions currently outsourced by U.S.-based health care management organizations.

URAC-accredited health plans and health networks are still responsible for oversight and final approval of all providers even when they delegate the task to outside vendors. They are also responsible to continuously monitor network physician and provider performance so that a quality network is maintained.

The issue brief also outlines URAC's proposed new standards module for transparency in provider performance measurement. Regulatory interest in evaluating network tiering practices is on the rise, punctuated by the recent settlement statement by New York's Attorney General which sets out new parameters for the way that state's health plans can equitably measure and report physician performance. URAC's proposed module provides a means for accredited organizations to demonstrate necessary transparency in performance benchmarking practices.

The brief, "URAC's proposed revisions for health plan, health network standards answer market outsourcing trend and demands for measurement," can be downloaded by visiting URAC's web site at http://www.urac.org/savedfiles/JuneNewswebHealthNetworks.pdf

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.
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