Response to Proposed URAC Measurement Guidelines Drives Development of Relevant, Timely PPO Metrics : Insurance News Onlypunjab.com- Insurance News

Response to Proposed URAC Measurement Guidelines Drives Development of Relevant, Timely PPO Metrics
Publish Date : 1/31/2007 8:41:00 AM Source : Insurance News Onlypunjab.com

Robust comments and suggestions from the PPO industry to an initial set of URAC health care management service measures introduced in September has underscored the need for metrics specifically relevant to the PPO industry.
The Consumer Value Based Health Purchasing Measures Project (CVBHPM), which will be applied across nine of URAC’s accreditation programs, targets measurement of health care management services to promote consumer protection and quality improvement. Rather than focus on clinical measures, URAC’s program will initially collect relevant information about consumer protection and empowerment and quality data for comparison across three general categories: service quality, consumer protection and empowerment, and satisfaction with services.

"We are moving forward to develop measures that take into account the broad array of benefit designs PPO plans offer, yet still will provide quality measures relevant to employers, purchasers and consumers," said Alan Spielman, URAC’s president and chief executive officer. "PPOs don’t follow a gatekeeper model, so metrics applicable to an HMO may not fit the PPO model. These health plans fulfill a valuable role in today’s market by offering purchasers a range of plan types and consumers a wide choice of providers. URAC’s metrics program will be pertinent for health plans of all types while recognizing the diversity in this market."

URAC has put forward three principles for CVBHPM:

•   Performance measures should address dimensions of health plan performance that the consumer values—specifically those that concern consumer choice;
•   Performance measures should target results that health plans are accountable for and have the ability to influence;
•   Performance measures should be based on data that can be collected and reported in a consistent fashion across the continuum of health benefit plans.

"Measurement is a key point of discussion now in the PPO industry," said Robert L. Crocker, MD, chairman of URAC’s Board of Directors and chief medical officer for American Specialty Health. "There is a genuine need for ongoing, meaningful metrics that demonstrate how accredited organizations deliver on their service commitment to consumers and clients. URAC’s measurement program is designed to enhance consumer education and empowerment while providing a means of comparison for health plans to improve quality."

CVBHPM will be phased in over several years and will be applied to URAC accreditation programs for Health Plan, Health Network, Health Utilization Management, Case Management, Disease Management, Health Call Center, Independent Review Organization, Health Web Site, and Workers’ Compensation Utilization Management.

URAC offered the initial set of measures for public comment in late 2006 and received a number of comments that have contributed to the further refinement of CVBHPM. The organization is conducting research to receive further input from purchasers and consumers as the standards development process advances.

URAC intends to Beta test the measures and begin collecting data from them in 2007. Starting in 2008, data collected through CVBHPM will be used to create a range of baseline data for participating companies to view and anonymously assess their performance as compared with the industry baseline. Only aggregate industry data will be publicly released during the initial two-year measurement and reporting period, although participating organizations would be free to independently release their individual data. URAC will later consider whether, with the consent and cooperation of participating organizations, to report individual company data to the public.

Sample measures would include tracking client or consumer satisfaction rates, complaint rates, provision of care coordination and consumer navigation tools, provision of price and quality transparency and provision of quality incentives.

CVBHPM will also give employers and purchasers the option to ask URAC-accredited companies to voluntarily release their individual measures so purchasers can make an "apples to apples" comparison of health plan performance.

"Our call for comments yielded valuable input, and we are seeking further input from purchasers, employers and consumers to ensure CVBHPM is germane and adds value," said John P. DuMoulin, MS, CAE, URAC’s vice president of government relations and product development. "Our goal is to create a monitoring program that underscores the value of URAC accreditation and provides URAC with a new measurement capabilities to accelerate adoption of quality best practices."

Frequently Asked Questions about the program:
http://www.urac.org/resources/CVBHPMFAQ.aspx

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. For more information, visit www.urac.org.

Note to Editors: If you would like to interview URAC CEO Alan P. Spielman, contact Health2 Resources at 703-319-0957

This press release was distributed through eMediawire by Human Resources Marketer (HR Marketer: www.HRmarketer.com) on behalf of the company listed above.

Onlypunjab.com

The Best Benefit in The Travel Insurance Industry Just Got Better Publish Date : 11/5/2007 7:25:00 AM
TravelSafe Insurance upgrades it's industry-first "Cancel For Any Reason" travel insurance benefit to cover up to 100% of travelers' non-refundable trip cost.

SASid and Markel Insurance Company Introduce Short Term Medical Health Insurance for Individuals and Families Publish Date : 11/5/2007 7:23:00 AM
SASid, Inc. and Markel Insurance Company announced today that they have joined together to offer short term health plans for individuals and families.

PrintsMadeEasy.com Announces Plans for New Line of Real Estate Business Cards Publish Date : 11/3/2007 6:26:00 AM
PrintsMadeEasy.com, the global leader in online printing solutions, today announced plans to release a new series of templates and designs for real estate business cards in 2008.

Sompo Japan Insurance Company of America Announces Selection of Millbrook and Oracle® Business Intelligence Solution Publish Date : 11/2/2007 7:16:00 AM
Millbrook Incorporated is pleased to announce that Sompo Japan Insurance Company of America has selected a solution based on...

Life Insurance Opportunities in Qualified Plans to be Focus of Nineteenth Annual Henry A. Deppe Lecture Publish Date : 11/1/2007 7:07:00 AM
Five financial experts will participate in Life Insurance Opportunities in Qualified Plans as part of The American College's nineteenth annual Henry A.

Lighthouse1 Announces CDH Event of the Year Publish Date : 11/1/2007 7:07:00 AM
Lighthouse1, the industry leading provider of consumer driven healthcare administration solutions, announced that Revolution '08, the first Lighthouse1 OnDemand™....

Partners Advantage Insurance Services, Inc. Merges with Maxx Financial Partners, LLC Publish Date : 11/1/2007 7:07:00 AM
Partners Advantage Insurance Services, Inc., and MAXX Financial Partners, LLC, announced today the completion of their merger, creating one of the ...

Website Exposes Dirty Little Secret of Private Mortgage Insurance (PMI) Publish Date : 11/1/2007 7:07:00 AM
Go.Toby.com, the popular real estate news and information website for Palm Coast, Flagler County, and Northeast Florida posts an article revealing ...

Silanis Sets the Record Straight on Electronic Contracting Myths Publish Date : 11/1/2007 7:07:00 AM
Leading electronic signature provider Silanis Technology has posted a recording of its recent Webcast, "Electronic Contracting - Dispelling the...

Employers Tackling Health Care Challenges with 21st Century Benefit Design Publish Date : 11/1/2007 7:07:00 AM
A new approach to health care in the 21st century should address the most acute challenges of our time and chart a new course through better use of data, ...

Total Results : 3507
More News (Opens in New Window) : [1] 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 Next Page

Canada News

Gadget News

Infotech News

Europe News

Health News

Middle East

Sports News

Advertising News

America News

Application News

Asia Pacific

Software News