Quality Improvement Projects

In its revision of Core 37, URAC has modified the requirements for its "error reduction/consumer safety" project.  There are two changes to note.  First, v. 2.1 adds "for the population served" to subsection (b), so that it now reads:

At any given time, the organization maintains no less than two quality improvement projects . . . (b) At least one quality improvement project focuses on error reduction and/or consumer safety for the population served. 

(Boldface indicates new language)

Presumably, this is to make sure that the applicant's submitted QIP under this subsection provides benefit that is focused on the consumers served by the module under review, and not  the public at large.

The second change that v. 2.1 makes to Core 37 is in subsection (b)(i), and is completely technical, spelling out the names of the accreditation modules that must submit consumer safet QIPs, as opposed to giving their initials ("Health Utilization Management" vs. "HUM").  

Like URAC, I appreciate clarity and am happy to sacrifice brevity on its altar on occasion. 

URAC, in v. 2.1 of Core, has merged two of the standards describing the requirement for quality improvement projects (QIPs), Core 35 and 36. The language of the two standards remains identical, so the only consequences of this change relate to the relative weight of an applicant's score on its QIPs as a percentage of the total Core score. In this sense, the change is similar to the merging of Core 21 and 22, which I described in an earlier blog and will repeat here:

By combining the two standards, URAC reduces the influence of an applicant's quality management program, and particularly its QIPs, at least marginally. The total number of points one can accumulate in the QM world is simply smaller as a percentage of the total number of Core points available in v. 2.1. The requirements of these standards now account for only 16 possible points, not 24, as was the case in v. 2.0.

However, the consequence of any mistake within this standard is increased by the change in weight from 3 to 4. Previously, any missed primary element (and most of the elements are primary) cost an applicant 9 points. In v. 2.1, with the higher weighting value, a mistake in a primary element has a price of 12 points.

As is often the case, a review of my blog on URAC scoring may be helpful at this point.