"URAC accreditation shows that Elixir is a pharmacy benefit management organization able to adhere to standards that cover important aspects of care such as claims processing, developing proper drug formulary, and consumer access," said URAC President and CEO Shawn Griffin, M.D. "Quality policies and procedures are paramount as the price and complexity of medications rise. Elixir chose to demonstrate their performance through URAC’s independent accreditation of their services."
Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.
URAC’s mission is to advance quality in healthcare through leadership, accreditation, measurement and innovation.
The URAC accreditation process demonstrates a commitment to quality services and serves as a framework to improve business processes through benchmarking organizations against nationally recognized standards. URAC accreditation requires applicants to submit policies, procedures, and other organizational information that is followed by a review. Once an application is received by URAC, a primary reviewer is assigned and coordinates all aspects of the review until a decision on accreditation has been determined.
URAC’s accreditation process enables learning and compliance with nationally recognized healthcare standards and supports improvements and innovation in healthcare management and delivery. URAC also offers educational content, including workshops, webinars, articles, issue briefs, videos, and white papers.
URAC’s Pharmacy Benefit Management Accreditation standards facilitate transparency by ensuring that accredited organizations have a mechanism for clients to verify that financial disclosures are comprehensive and accurate.
Customer service and communication are key elements of URAC’s standards, which provide for enforcement of ongoing communications (in multiple formats) and communication safeguards. Standards for pharmacy distribution channels address key issues related to access, availability, quality and safety across retail, mail order and specialty pharmacy channels. URAC’s drug use management standards include areas of special interest to consumers and purchasers, including coverage decisions, clinical review criteria, consumer safety process requirements and the appeals process.
URAC’s standards help accredited organizations focus formulary decisions on the safety, efficacy and therapeutic need for drugs first, and focus on cost only after these considerations are met.
Drug therapy management (DTM) is an expanding, complex and necessary function in the healthcare system. DTM is a distinct service or group of services that optimize drug therapy to improve therapeutic outcomes for individuals. It includes a range of professional activities, such as performing patient assessments and a comprehensive medication review, formulating a medication treatment plan, monitoring efficacy and safety of medication therapy, enhancing medication adherence through patient empowerment and education, and documenting and communicating DTM services to prescribers to maintain comprehensive care.
URAC’s DTM Accreditation standards cover the essential parts of a DTM business, including driving appropriate therapeutic outcomes for consumers and reducing adverse events; promoting rational, clinically appropriate, safe, and cost-effective DTM through evidence-based medicine; encouraging communication about medication use; supporting population specification, consumer identification, and recruitment; and creating a process for DTM outcomes measurement and quality improvement.