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URAC is a Washington, DC–based non-profit organization [1] that provides accreditation of organizations involved in medical care services, as well as education and measurement programs. Founded under the name Utilization Review Accreditation Commission in 1990, the name was shortened to the acronym URAC in 1996. [2]
This task force considered that drug utilization review was potential but this review should be evaluated and need valid evidence to put into effect. [7] In 1970, Drug utilization review program was carried out by a private pharmaceutical management company. It focused on the cost of another program. [7]
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Free Resources for Program Evaluation and Social Research Methods This is a gateway to resources on program evaluation, how to, online guides, manuals, books on methods of evaluation and free software related to evaluation. Innovation Network A nonprofit organization working to share planning and evaluation tools and know-how. The organization ...
HCUP Logo. The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Formal utilization review and quality improvement programs including disease management and case management; An emphasis on preventive care including wellness incentives and patient education; The techniques can be applied to both network-based benefit programs and benefit programs that are not based on a provider network.
After that, the program would start to rely on reserve funding, at which point furloughs at the U.S. Department of Agriculture, which administers SNAP, could begin to affect benefits distribution.
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.