Johns Hopkins HealthCare LLC (JHHC) has earned accreditation from the Utilization Review Accreditation Commission (URAC), a Washington, D.C.-based organization that establishes standards for the health care industry covering network management, provider credentialing, utilization management, quality improvement and consumer protection.

 Founded in 1995, JHHC develops and manages medical care contracts with managed care organizations, government programs, employers, hospitals, physicians and other health care providers. Its principal programs are the Employer Health Programs, which administers self-insured health benefits plans on behalf of the Johns Hopkins employer groups and other strategic partners; Priority Partners, a managed care organization, which provides benefits for Medicaid beneficiaries; and Uniformed Services Family Health Plan, which provides health care services for dependents of active military or retired military personnel through a Department of Defense contract.

 All told, JHHC manages care delivery for almost 200,000 members.

 “Receiving health plan accreditation from URAC serves as recognition of Johns Hopkins HealthCare’s commitment to world-class care, quality and innovation, as well as the strength and quality of our relationships with our network providers, clients, and members,” says Patricia M.C. Brown, president of Johns Hopkins HealthCare.

In addition to benefits administration services, JHHC offers sophisticated care management and disease management using advanced technology, evidence-based care and staffing models designed especially for people with catastrophic or chronic conditions.

To achieve URAC’s health plan accreditation, JHHC was required to establish goals and measure performance related to access to care, availability of providers and provider selection criteria. JHHC also had to implement policies assuring consumers access to covered services not available through participating providers and emergency care both in and out of a network. This is the first time Johns Hopkins HealthCare applied for full health plan accreditation.

URAC is an independent, nonprofit organization that promotes health care quality through accreditation and certification programs. Originally, URAC was incorporated under the name "Utilization Review Accreditation Commission." However, that name was shortened to just the acronym "URAC" in 1996 when URAC began accrediting other types of organizations such as health plans and preferred provider organizations.