Summary: What is the value of accreditation and, specifically, URAC Pharmacy Benefit Management Accreditation? How do you attain assistance if you are seeking accreditation?
Who is URAC?
URAC is an independent, nonprofit organization, which provides national recognition to organizations which have attained and maintain high standards of quality and excellence. URAC constantly monitors the healthcare industry to continually assess gaps which can benefit from accreditation and quality indicators. New accreditation programs are being added, standards are being revised, and the levels of bar for which excellence is measured is constantly being raised. Currently, URAC offers 30+ accreditation and/or certification programs in the areas of Health Care Management, Health Care Operations, Health Information Technology, Pharmacy Quality Management, Pharmacy Benefit International, Patient Centered Medical Homes, Credentialing Support and Vendor.
What is the value of URAC Accreditation?
- URAC is the national leader in promoting quality health care
- URAC Accreditation exudes a feeling of trust and confidence from an independent, unbiased, third-party expert.
- URAC Accreditation promotes industry best practices.
- URAC Accreditation encourages a state of constant quality measurement and improvement.
- URAC Accreditation provides public information as to the organizations which are either accredited or in-process.
What is Pharmacy Benefit Management (PBM)?
According to URAC, a PBM is defined as “an organization that provides administrative services in processing and analyzing prescription claims for pharmacy benefit and coverage programs.
What functions might a PBM perform?
- Contracting with a network of pharmacies
- Establishing payment levels for provider pharmacies
- Negotiating rebate arrangements
- Developing and managing formularies, preferred drug lists, and prior authorization programs
- Maintaining patient compliance programs
- Performing drug utilization review
- Operating disease management programs
- Operating mail order pharmacies or have arrangements to include prescription availability through mail order pharmacies.
PBMs play a key role in managing pharmacy benefit plans in the Medicare drug program.
What is the value of URAC Pharmacy Benefit Management Accreditation?
URAC was the first accrediting body to determine the need for PBM Accreditation and to date is the only organization to offer this type of accreditation. The concept was originally drafted in 2006 and became effective in 2007. Pharmacy Accreditation and PBM Accreditation, in particular, is a way of demonstrating that quality and excellence are not only important, but a key focal point of your organization. PBM Accreditation clearly spells out the organization’s contract terms and pricing structure so there are no surprises. It provides transparency to the public. URAC PBM Accreditation provides a competitive advantage and a level of prestige over other organizations which have opted not to pursue accreditation. PBM Accreditation provides a level of confidence and trust which the public is desperately seeking. PBM Accreditation, as with any type of URAC Accreditation is not a one shot deal. It is a commitment to continually providing and improving quality care. New standards are constantly being assessed.
About BHM Healthcare Solutions – www.bhmpc.com
BHM is a healthcare management consulting firm whose specialty is optimizing profitability while improving care in a variety of health care settings. BHM has worked both nationally and internationally with managed care organizations, providers, hospitals, and insurers. In addition to this BHM offers a wide breadth of services ranging including managed care consulting, strategic planning and organizational analysis, accreditation consulting, healthcare financial analysis, physician advisor/peer review, and organizational development.
How can BHM assist you with Pharmacy Accreditation?
BHM is currently assisting and has successfully assisted several organizations in attaining Pharmacy Accreditation. Our Pharmacy Consultants recognized the growing need in the Pharmacy Accreditation field and have created an invaluable niche. If you need assistance with any of the URAC Pharmacy Accreditations: (Pharmacy Benefit Management, Drug Therapy Management, Specialty Pharmacy, Mail Service Pharmacy, or Workers Compensation Pharmacy, please don’t hesitate to contact us. We are looking forward to working with you.
Contact Us : firstname.lastname@example.org, 1-888-831-1171