Heads-up: URAC adopts updated scoring system
New approach should reduce variability
If you’ve put off the accreditation process or are up for renewal soon, read up, because the rules are about to change. A new scoring system which will begin later this year and be fully implemented by mid-2002 should improve inter-rater reliability and provide enhanced feedback to organizations seeking accreditation for their case management departments and other services from the Washington, DC-based American Accreditation HealthCare Commission, more commonly known as URAC.
Gary Carneal, JD, MA, president and chief executive officer of URAC, says the organization is always exploring new ways to make the accreditation process more efficient and effective. "The new scoring methodology is one example of URAC’s continuing development as an accreditation organization."
The current scoring methodology is based on "shall" standards and "should" standards. Applicants must comply with 100% of shall standards and 60% of should standards to achieve accreditation. These standards are scored by URAC raters on a pass/fail basis. (For more information on accreditation of case management programs, see Case Management Advisor, December 1998 and December 1999.)
Beware the heavyweights
The new scoring system replaces shalls and shoulds with numerical weights that indicate a standard’s relative importance. Numerical ratings will replace the pass/fail methodology, and under the new system, organizations will earn higher ratings by demonstrating greater compliance with the standards. The weights and an applicant’s ratings will be combined to provide an overall score upon which URAC’s Accreditation Committee will base its accreditation decision.
The new scoring system provides some flexibility yet it maintains the concept of mandatory standards set in URAC’s current "shall" standards, notes Carneal. Under the new system, standards with the highest numerical weights will be "mandatory standards." Organizations that fail to meet all the mandatory standards will not earn URAC accreditation, regardless of their overall score.
"The purpose of the mandatory standards is to ensure that all URAC-accredited organizations provide fundamental protections for patients’ rights and safety," says Carneal.
He notes that URAC will not apply the new scoring system to the current versions of accreditation standards. Instead, the new scoring rules will be incorporated into each set of accreditation standards as they are revised. The first set of standards scheduled for revision is URAC’s health utilization management accreditation program.
For more information about the new scoring methodology, or other URAC accreditation issues, call (202) 216-9010, or visit URAC’s Web site at www.urac.org.
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