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URAC Announces Revised Case Management Accreditation Standards and Measures
Date:12/17/2008

also require organizations to produce and report to URAC on a specified set of performance measures. These measures can be used by accredited organizations for internal performance improvement and for reporting to customers, or for direct reporting to the public. In the future, URAC's accreditation process will include public reporting of the measures. The measures include medical readmissions, timeliness of complaint resolution, overall consumer satisfaction, and measures for service dimensions for health care, behavioral health, and workers' compensation case management programs.

"Measurement provides an opportunity for case management organizations to evaluate their processes and determine areas for improvement," said Joann Richards, PhD, RN, URAC's vice president for research and measurement. "The mandatory measures are designed to address multiple performance domains."

Other major changes to the standards include:

  • Promotion of evidence-based case management practices;
  • Revisions to address the full complement of medication management as an integral component of patient safety (i.e., medication knowledge, adherence and reconciliation);
  • Clarification of specific aspects of writing case management goals;
  • Expansion of the role of case review to address all levels of performance assessment;
  • Update and clarification of case management staff training and role requirements, to include training in evidence-based care plans and more specific topics for training content; and
  • Clarification of qualifications for case managers and those supervising them, as well as the role of non-case managers in the case management process.

"URAC has been a leader in case management accreditation, and these major revisions demonstrate our commitment to creating meaningful standards that will serve the industry and
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SOURCE URAC
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