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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]
Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary Provider Programs"
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 ...
HMOs also manage care through utilization review. That means they monitor doctors to see if they are performing more services for their patients than other doctors, or fewer. HMOs often provide preventive care for a lower copayment or for free, in order to keep members from developing a preventable condition that would require a great deal of ...
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.
Additionally, there are alternative national medical boards, i.e. the National Board of Physicians and Surgeons, [10] with over 10,000 board-certified physicians, that meet national quality standards, including the Joint Commission, the National Committee on Quality Assurance, and the Utilization Review Accreditation Commission, and has gained ...
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [1] [2] A discipline-specific process may be referenced accordingly (e.g., physician peer review, nursing peer review).
OhioHealth Doctors Hospital is a 213-bed tertiary care teaching hospital located in Columbus in the U.S. state of Ohio. Doctors Hospital operates the second largest osteopathic medical training program in the United States. Each year, the hospital trains 160 physicians in residencies and fellowships.