Measures of Quality

Performance Measures

URAC- Performance Measures for Workers' Compensation Managed Care Organizations

These performance measures represent a standardized framework for reporting information about the quality and effectiveness of medical care provided under workers' compensation managed care arrangements. The measures are modeled after a similar tool used by group health maintenance organizations (HMO's) called HEDIS (www.ncqa.org). The URAC measures were developed based on expert recommendations after review of the best available scientific evidence, as well as the opinions of URAC's advisory committee. The data collection tools presented in the "Tool Box" will help managed care organizations, payors and regulators analyze the quality of medical service being provided to injured workers and help them improve the quality of care.

• List of Performance Measures and Rationale
  
  
• Injured Worker Survey
  • Survey of Worker Experience
  • Survey Implementation Procedures
  • Analysis of Survey Data
  • Sample Survey Report Formats

• Measures from Claims Data
  • Sample Survey Report Formats
  • Definitions of Categories of Service

• Measures from Medical Record Data
  • Record Review for Clinical Quality
  • Medical Record Audit Form
  • Medical Record Audit Instructions