The URAC Report

Achieving URAC’s Clinical Integration Accreditation has resulted in many unexpected efficiencies and improvements for St. Vincent’s Health Partners (SVHP). But not just clinically.

Each year, NAIRO and its members stage an annual Symposium discussing the latest developments and trends in independent medical review. The Symposium delivers in-depth educational content, along with networking opportunities to meet and exchange ideas. The theme for the three-day event is "Trust in Healthcare," highlighting security, regulatory, and legal topics as IROs work in a changing healthcare environment.

Telehealth is a promising new avenue for providing greater access to care for countless patients. However, not all healthcare organizations are ready to press forward on a fully developed program. 

Robust measurement and accreditation programs are key components of a successful telehealth program, leading experts say.

“There shouldn’t be any difference between a quality telehealth visit” and a traditional in-office doctor visit, says Marybeth Farquhar, vice president, quality, research and measurement, URAC.

When New York-based Westchester Medical Center Health Network (WMCHealth) decided in 2015 to launch a telehealth program across its 6,200-square-mile service area, the 10-hospital network opted to build it from scratch, investing more than $7 million in technology and infrastructure.

With the transition to value-based healthcare and the growth of Accountable Care Organizations (ACOs), healthcare providers and payers are looking for ways to overcome barriers to meeting population health goals.

While CINs enable health systems and providers to deliver value-based care, they come with many clinical and operational challenges, including in those related to technology, governance, organizational alignment and care coordination. And there are very real compliance threats. The U.S. Federal Trade Commission, Department of Justice and state regulators closely scrutinize the structures of these networks to safeguard against antitrust violations.

The telestroke program at Penn State Hershey Medical Centers (PSHMC) has dramatically improved care for stroke victims and sets a high bar for other organizations looking to follow suit.