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URAC Introduces New Performance Measures and Reporting Standards for Pharmacy Benefit Management and Drug Therapy Management Accreditation
Date:10/1/2009

ns, such as development of clinical formulary policies using evidence-based medicine; patient and prescriber communication regarding medication use; and promoting consumer and prescriber rights, shared decision making and consumer education. The revised standards went into effect in July 2009.

New performance measures in PBM and DTM Version 2.0 allow organizations to show employers and other purchasers quantitative results related to consumer engagement, cost effectiveness, and consumer and client satisfaction. These measures will address areas such as medication possession ratios to assist with medication adherence, dispensing rates for generic medications, timely resolution of complaints, consumer satisfaction rates, and call center performance.

Measurement reporting will use a multi-year, three phase approach. First, organizations report mandatory measures to URAC, placing a particular focus on internal performance improvement and oversight activities. Phase two requires those measures be externally audited or verified, and URAC then makes composite measurement data available to participating organizations and interested third parties. In the last phase, URAC publishes the detailed public reports on its website with specific information by organization. URAC accredited pharmacy benefit management organizations and drug therapy management organizations will submit performance measurement reporting on these measures in 2011 for the 2010 reporting year. URAC accredits over 20 of the nation's leading pharmacy benefit management and drug therapy management organizations serving millions of consumers.

"It is important that URAC's standards stay current with changes in the industry. By developing measures for functions including evidence-based medicine and consumer rights, we can encourage improvement and innovation in the marketplace, and set standards that challenge organizations to empower and protect consumers," said John Jones, RP
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