Key Takeaways for the URAC 2024 Performance Measurement Reports
March 4, 2025
URAC recently released its 2024 performance reports (Performance Measurement Results - URAC) for specialty pharmacies, mail service pharmacies, and pharmacy benefit management (PBM) organizations.
Key takeaways include the following:
- 99.9+% of prescriptions are filled with no dispensing or distribution errors.
- When a dispensing error occurred, it was most likely due to incorrect quantity.
- When a distribution error occurred, it was most likely delivered to the wrong location despite having the correct patient address.
- On average, mail service pharmacies fill prescriptions within 1.93 days and specialty pharmacies within 6.01 days.
- For mail order pharmacies and PBMs, 97+% of prescriptions are dispensed as generics, branded generics or brands for which members paid a generic co-pay.
Performance measurement for the 2024 reporting year aligns with Phase 2 of URAC’s measurement process where mandatory performance measures are subject to an external data validation process.
With the URAC 2025 reporting cycle starting soon, there is still time to identify areas of opportunity for improvement and ensure ongoing compliance with program standards for this or next year.
Questions? Contact us at
info@adventadvisorygroup.com and we will connect you with one of our URAC performance measure specialists.
Advent Advisory Group Insights
NCQA has opened the 2026 HEDIS® Public Comment period, running from February 13 through March 13, 2026.
CMS has released its CY 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.
The CMS 2026 Program Audit Annual Updates bring several important changes that healthcare sponsors must address to stay compliant. These updates affect various aspects of the audit process, from condition classifications to new requirements for validation audits.
Aside from the usual updates to the audit timeline and other wording changes, this year’s HEDIS audit manual includes several changes of significance.
The Advent team had the opportunity to attend the NCQA Health Innovation Summit, where healthcare leaders and innovators came together to explore the next phase of digital quality measurement and value-based care.
HEDIS is shifting. Stars are flattening. Advantage goes to plans that act now. After several consecutive years of declines, the average Medicare Advantage (MA) Star Ratings are essentially flat for 2026.
As California leaders assess the sweeping implications of these proposed changes, Advent Advisory Group is helping health plans evaluate exposure, model financial impacts, and prepare operational strategies across Medicare, Medi-Cal, and Commercial lines.
The 2025 NCQA Health Plan Ratings are out. For health plans, these results are more than just numbers — they’re a public reflection of quality, experience, and performance.
CMS recently published its annual Part C and Part D Program Audit and Enforcement Report. The report provided recommendations and guidance for Sponsors to consider when preparing for future CMS Program Audits.
Advent’s HEDIS 2026 webinar series kicked off last month with Optimizing Clinical Data Quality, a presentation focused on common challenges with supplemental clinical data. Key takeaways include the following: Transition in Data Collection: The shift from manual data collection to digital HEDIS reporting has increased the focus on clinical data over claims data. NCQA’s planned elimination of the hybrid reporting method has added urgency to this transition, driving plans to acquire more electronic clinical data and adapt to year-round ingestion. Challenges with Clinical Data: The presentation highlighted several challenges to the acquisition of supplemental clinical data, including data timing, completeness, and accuracy. Issues such as short turnaround times, missing biometric values, and incorrect coding have impacted the useability of these additional data sources for HEDIS reporting. Tips for Navigating the Transition: Plans can navigate this transition by starting early with clinical data validation, engaging with IT departments, exploring vendor’s reports and supportive capabilities, and building executive leadership buy-in.
