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SUBMISSION GUIDELINES - ENTRIES DUE SEPTEMBER 15, 2008
Eligibility & Criteria |
Five types of organizations are eligible to submit entries:
- Health Information /Decision Support Companies
Examples include health information technology and patient based empowerment protocols.
- Health Management Companies
Examples include CM, DM, UM, IROs, call centers, wellness, and DTM.
- Health Plans and Health Networks
Examples include HMOs, PPOs, IPAs, TPAs, and specialty provider groups.
- Pharmacy Quality Management Companies
Examples include PBMs, mail service pharmacy and specialty pharmacy.
- Workers’ Compensation Companies
Examples include worker’s compensation management programs or companies and workers’ compensation insurance programs or companies that serve workers’ compensation populations.
Entries will only be permitted from these five types of organizations and their business partners. All entries must indicate the primary (and secondary, if applicable) organization type that best represents the principal company that leads and implements the practice. These organizations can be independent companies or subsidiaries of larger corporations . There’s no requirement or consideration given for URAC-accredited organizations.
All entries should feature a practice that:
- Measurably demonstrates its purpose, as well as its impact on the two topics of the awards categories: (1) consumer decision-making and/or (2) consumer health improvement;
- Involves collaborative partnership activity intra- and/or inter-organizationally between and among different providers, vendors, and departments; and
- Exhibits a potential for wide-spread implementation .
URAC intends to present Gold, Silver, and Bronze awards in each of the five organization type categories as well as Platinum awards in each of the two topic categories: Consumer Decision-Making and Consumer Health Improvement. Entries that do not meet the criteria for a best practice, yet represent an emerging practice, may be selected as honorable mentions. Practices that won a 2008 Best Practice or Gold Award are not eligible to be resubmitted for the 2009 Awards Program, unless the practice has been enhanced in 2008.
Description of Awards Categories |
These are programs designed to directly impact the consumer/patient where the outcome metric(s) are open (e.g., financial, satisfaction, clinical or other). A direct impact program is between the applicant and the consumer (e.g., applicant’s web site on disease-specific education; a social networking web site targeted
to consumers with a specific disease; health coaching between provider and patient where decisions are not just based on clinical evidence, but include ethics, life-style choices, etc.).
Consumer Health Improvement: Practices that are broadly related to quality improvement in patient safety (safe, effective, patient-centered, timely, efficient and equitable) —including care coordination between providers— or consumer health quality improvement for the purpose of protecting the consumer where
outcomes are limited to health/clinical metrics (e.g., a measure of adverse event reduction or prevention) or health quality improvement that protects the consumer from a short-term or long term health related adverse event (e.g., primary, secondary or tertiary prevention).
Examples of programs that are “Safe” include credentialing, practice guidelines, UM/CM/DM triggers, privacy; “Effective” include provider feedback, peer review, quality management programs; “Patient-centered” include individualized focus, and informed decision-making, patient satisfaction, consumer education, and health literacy; “Timely” include timeframes/caseloads defined, enhanced care coordination; “Efficient” programs include organizational structure, policies and procedures, TQM; and “Equitable” include appeals and grievances, review criteria, and cultural sensitivity. Examples of health quality improvement are those programs that reduce the probability of adverse health/disease events in the short or long term (e.g., immunizations toprevent measles, blood glucose control to prevent amputations, pain control to prevent suffering at end of life). One key factor distinguishing this topic from the other is the requirement that the outcome metrics in this category are limited to those related to health or clinical factors.
Submission Requirements |
- Complete company contact information including CEO and media representative, and brief company description;
- Letter of support from company’s CEO (acknowledging approval of submission);
- Authorization for URAC to use entry information to promote best practices outreach efforts;
- Title of the practice and topic category that best represents the focus of the practice; and
- Narrative description of the practice (limited to 12 pages or 6,000 words) to include:
Problem Statement: Background of the issue/problem that the practice is designed to solve and the extent to which the practice demonstrates the specific components related to consumer decision-making (including transparency) and/or consumer health improvement (including care coordination). 15%*
Practice Description: Summarize the intervention part of the practice, including the implementation process. Describe the degree to which the intervention/ program includes collaborative activity and addresses the problem detailed in the problem statement. Describe the primary and secondary goal(s) of the project. 15%*
Practice Process Metrics: Describe the metric(s) (definition, numerator, and denominator) used to measure the process /intervention of the practice. Describe the results of these metrics, showing both numerator and denominator values. 20%*
Targeted Outcomes Metrics: Describe the metric(s) (definition, numerator, and denominator) used to measure the outcomes targeted by the practice. Describe the results of these outcome metrics, showing both numerator and denominator. Describe the change in the targeted outcome metric(s) from baseline. Describe how it compared to the expected results without the practice, e.g. from a reference group. 20%*
Methodology: Acknowledge factors besides your practice that could have influenced the results in the outcome metrics. Describe how you are dealing with these issues. Describe the methods used to take all or some of these into account (or why you were unable to do so). Describe the estimated benefit of the practice on consumers/patients. 20%*
Relevance: Address the extent to which the practice could be implemented elsewhere regardless of proprietorship and become a national best practice. Supply a useful cost estimate of the practice (e.g. PMPM). 10%*
* indicates scoring weight
Upon receipt of your entry via the online submission form, an email acknowledgement will be sent. After the submission deadline, all entries will be reviewed to confirm that they are complete and conform to the submission guidelines. During this initial review, we will contact you directly if there are any questions about
your entry. URAC reserves the right to reject incomplete entries and reassign topic categories and/or organization types.
Award Winners |