Originally incorporated under the name Utilization Review Accreditation Commission, URAC is an independent, non-profit accreditation entity with a stated mission to “advance health care quality through leadership, accreditation, measurement and innovation.” Founded in 1990 in Washington, D.C., the full name was shortened to URAC when it began accrediting other types of organizations such as health plans, pharmacies and provider organizations.
The basic beliefs held by the URAC-accredited organization are:
- The patient is at the center of everything we do.
- The provider’s voice must be heard.
- The best approach to care delivery is through physician-led teams.
- Healthcare solutions must be local to be sustainable.
- Continuous improvement is achieved through performance measurement.
The organization takes a learning approach to the accreditation process and takes a genuinely client-based approach to uphold URAC’s exceptional standards.
Accreditation through URAC usually takes approximately 10-12 months to complete and involves a 5-step process.
- Two-part application process: An account manager is assigned to aid clients in the application process. First, the client must receive approval by URAC as an applicant. Then, the client must upload the required information to the URAC web portal.
- Desktop review. In this stage, the information uploaded by the URAC applicant is reviewed to ensure compliance. The applicant has the opportunity to address any deficiencies that arose during the application process through a request for information. This review takes 30-45 days.
- Validation review. In this stage, a member of URAC will visit the organization. During the visit, leadership and staff members are interviewed and systems, work processes, and policies and procedures outlined in the desktop review are validated. The organization’s URAC score will then be generated based on information collected by the surveyor.
- Committee review. This is a formal assessment of the organization by the URAC Accreditation Committee. The committee consists of experts in healthcare fields relevant to the specialty pharmacy accreditation. Validation review findings and the score from the surveyor will be considered to determine the application status. This review normally takes one week, and then the committee will notify the applicant of their results.
- Once accreditation is received, URAC will regularly monitor the organization to make sure they are maintaining standards and are in compliance. Requirements may include collection and annual reporting of quality measures, as well as a mid-cycle onsite review with 14 days’ notice. Specialty pharmacy accreditation is awarded for a period of 3 years, after which a member of URAC will conduct another visit to validate that accreditation may be maintained.