Workshop to revise and update Pharmacy Benefit Management and Drug Therapy Management

URACOct 5 2009

Changes To Be Promoted at 10th Annual Quality Summit

URAC, the nation's leading health care accreditation and education organization, will introduce new performance measures and reporting standards to its Pharmacy Benefit Management (PBM) and Drug Therapy Management (DTM) Accreditation programs at a workshop focused on the latest revisions and updates to the standards. The workshop, scheduled for October 6, 2009 at URAC's 10th Annual Quality Summit and Exhibition in Tucson, AZ, will be conducted by Janice Anderson, RPh Director of Pharmacy Programs for URAC, and will guide participants through standards changes reflected in PBM and DTM Version 2.0 and review the new accreditation requirements for performance measurement reporting.

"With one in every five health care dollars spent on prescription drugs, there is a critical need to maintain national standards and assure consumers that ongoing accountability and quality best practices will continue to be a major focus for URAC-accredited companies," said Alan P. Spielman, president and CEO of URAC. "PBM and DTM programs are expanding rapidly, and these new standards will enhance patient safety, assure timely access to prescription medications and improve medication therapy management across this country."

URAC's Pharmacy Benefit Management and Drug Therapy Management standards establish benchmarks that evaluate organizational integrity, clinical areas, operations, and marketing and communications. This year, URAC's Pharmacy Accreditation Advisory Group revised the standards in order to tackle a broad range of program functions, 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, RPh, JD, chairman of URAC's Pharmacy Accreditation Advisory Group and vice president of professional practice and pharmacy policy at Prescription Solutions. "These new accreditation standards are designed to help organizations drive appropriate therapeutic outcomes for consumers with a clear focus on patient safety, outcomes measurement and quality improvement."

The Pharmacy Accreditation Advisory Group is comprised of 38 members representing a wide range of professionals from the health care sector, including employers, consumers, pharmacy consultants, health plans, independent retail pharmacy, pharmacy benefit management organizations, pharmacy professional organizations, labor, and large purchasing groups such as the Office of Personnel Management.

The PBM and DTM Accreditation Standards workshop will begin at 8:30 a.m. on October 6, 2009 with an overview of the standards and review of the re-accreditation process. The full-day session will also cover URAC's core accreditation standards. The workshop is being held in conjunction with URAC's 10th Annual Quality Summit which runs October 6-8, 2009 at the Hilton El Conquistador Resort in Tucson, AZ.