Accreditations and ratings
Blue Cross and Blue Shield of Kansas earns trust from our members by achieving recognized accreditations.
Accreditations
Utilization Review Accreditation Commission (URAC) is a national organization that promotes improvement in the quality of health care management through accreditation, education and measurement. Accreditation by URAC validates for members that we are focused on quality improvement and that we conduct activities in a manner consistent with national best practice standards. Accreditation is an external seal of approval of our quality and customer service activities.
Health Plan
Commercial products, health insurance marketplace
According to URAC, URAC's health plan accreditation standards address key issues stated in the Affordable Care Act (ACA) requirements, focusing on quality improvement activities that promote patient safety across many channels including but not limited to: wellness and health promotion, utilization management, care coordination, mental health parity, medication safety and care compliance, and patient experience of care.
Obtaining this accreditation demonstrates that Blue Cross and Blue Shield of Kansas:
- Conducts business in a manner consistent with national standards
- Offers clients, members and providers reassurance that their health plan members are being managed by an organization that meets national clinical and quality standards
- Has the infrastructure necessary to meet the ever-changing needs in the health care landscape
Case Management
URAC indicates health plans accredited in the case management standards enable organizations to successfully train case managers, identify individuals for case management, manage and conduct case management activities in an efficient and professional manner, promote the autonomy of consumer and family decision making, maintain confidentiality and delegate responsibility.
Disease Management
URAC works one-on-one with each organization to create a tailored program from the ground up – a program that is fully documented, employs a valid evaluation process, reports on its performance, seeks provider feedback and respects consumers. Coupled with the core standards, obtaining URAC’s disease management accreditation ensures that organizations:
- Implement a process to assess the health condition of each participant, taking into account cases where more than one chronic health condition may be present
- Conduct assessments according to a standard process
- Implement interventions designed to respond to the specific health needs of the patient
- Employ evidence-based decision-support tools that are reviewed and updated annually
Ratings
Ratings represent the company's financial strength and its ability to pay claims to policyholders.