Patients choosing a specialty pharmacy or infusion provider usually begin with practical questions.
Will my insurance cover treatment?
Can the pharmacy provide my medication?
Can I receive therapy at home?
How quickly can prior authorization be handled?
Will someone be available when I have questions?
Those are important questions. But there is another factor that patients and referring providers may want to consider:
Is the organization independently accredited?
Mercy Infusion states that it maintains accreditation from both URAC and the Accreditation Commission for Health Care, or ACHC. (Mercy Infusion)
Maintaining two nationally recognized accreditations is not simply about displaying additional logos on a website.
Accreditation requires healthcare organizations to demonstrate that their policies, procedures, quality systems, clinical processes, and operational practices meet standards established by independent organizations.
For Mercy Pharmacy Group, maintaining both URAC and ACHC accreditation provides two external frameworks for continually evaluating how specialty pharmacy and infusion services are delivered.
What Is Healthcare Accreditation?
Healthcare accreditation is an independent evaluation process.
An accrediting organization establishes standards for a particular type of healthcare service. The healthcare organization seeking accreditation must demonstrate that it meets those requirements.
Depending on the accreditation program, reviewers may evaluate areas such as:
- Patient safety
- Clinical operations
- Pharmacy practices
- Medication management
- Quality improvement
- Staff qualifications
- Policies and procedures
- Patient communication
- Documentation
- Risk management
- Regulatory compliance
- Performance measurement
Accreditation therefore goes beyond an organization simply describing itself as high quality.
An independent organization reviews whether defined standards are being followed.
What Is URAC?
URAC is an independent healthcare accrediting organization with multiple accreditation programs related to pharmacy and healthcare services.
Its pharmacy programs include Specialty Pharmacy Accreditation, Infusion Pharmacy Accreditation, Medicare Home Infusion Therapy Supplier Accreditation, and other pharmacy-related programs. URAC describes Specialty Pharmacy Accreditation as applying to pharmacies that dispense specialty medications and provide patient-management services. (URAC)
URAC’s specialty pharmacy framework emphasizes areas such as:
- Patient management
- Quality measurement
- Risk management
- Patient satisfaction
- Continuous improvement
- Pharmacy operations
URAC also requires eligible specialty pharmacies to be licensed pharmacies in good standing in the United States. (URAC)
What Is ACHC?
ACHC stands for the Accreditation Commission for Health Care.
ACHC offers accreditation programs covering numerous healthcare settings, including pharmacy and home infusion therapy.
Its infusion-related accreditation programs include areas such as infusion pharmacy, pharmacy infusion nursing, and home infusion therapy. ACHC states that applicable requirements must be met to achieve and maintain accreditation, and certain home-infusion programs incorporate Medicare requirements. (ACHC)
For patients receiving complex medications outside a hospital, that external evaluation can provide another layer of assurance that the organization operates within a defined quality framework.
Why Maintain Two Accreditations?
URAC and ACHC are separate organizations.
Each has its own:
- Standards
- Accreditation process
- Review methodology
- Quality framework
- Program requirements
Maintaining both allows Mercy to evaluate its operations through more than one independent quality framework.
That does not mean one organization is inherently better than the other.
Instead, each accreditation can reinforce an organizational culture centered on:
- Consistency
- Accountability
- Quality
- Patient safety
- Documentation
- Process improvement
For a specialty pharmacy managing complex therapies, those principles are important.
Specialty Pharmacy Is More Than Dispensing Medication
Traditional pharmacy may involve receiving a prescription, filling it, and providing the medication to the patient.
Specialty pharmacy is often much more complex.
A patient may need help with:
- Insurance benefits verification
- Prior authorization
- Clinical documentation
- Medication access
- Copay assistance
- Financial-support programs
- Nursing
- Medication delivery
- Treatment scheduling
- Ongoing authorization
- Physician coordination
Some patients receive therapy for months or years.
That means quality systems must support not only the first prescription, but also the entire ongoing patient journey.
URAC specifically defines Specialty Pharmacy Accreditation around both dispensing specialty medication and providing patient-management services. (URAC)
Accreditation Supports Consistent Processes
In healthcare, consistency matters.
A patient should not receive a completely different experience simply because one employee is working that day instead of another.
Accreditation encourages organizations to create documented processes for important activities.
These may involve:
- Prescription intake
- Patient identification
- Medication dispensing
- Clinical assessment
- Documentation
- Medication delivery
- Patient complaints
- Quality reporting
- Staff training
- Risk management
Written policies alone are not enough.
Accredited organizations must also demonstrate that applicable standards are being followed.
Accreditation and Medication Accuracy
Medication accuracy is especially important in specialty pharmacy.
Many specialty therapies involve:
- Complex dosing
- Weight-based dosing
- Specialty formulations
- Refrigerated medication
- Infusion supplies
- Strict administration schedules
URAC has historically required accredited specialty pharmacies to report performance measures including dispensing accuracy, distribution accuracy, turnaround time for prescriptions, and call-center performance. (URAC)
Measurement creates an opportunity to identify problems and improve processes rather than relying only on assumptions.
Accreditation and Patient Communication
Patients receiving specialty medication often have questions that extend well beyond how to take the medication.
They may ask:
- Has insurance approved my treatment?
- When will medication arrive?
- Is my nurse scheduled?
- What happens if my insurance changes?
- Who do I call after hours?
- Is financial assistance available?
Mercy Infusion states that patients have access to support for urgent clinical needs and that a pharmacist is available after hours for urgent concerns. (Mercy Infusion)
Accreditation frameworks can reinforce the importance of having defined systems for communication and patient support.
Accreditation and Continuous Quality Improvement
One of the most important concepts behind accreditation is that quality should not be treated as a one-time project.
URAC describes its specialty pharmacy accreditation process as providing a roadmap for ongoing improvement and requiring quality measurement and risk-management processes. (URAC)
Healthcare changes constantly.
Organizations must adapt to:
- New medications
- New payer requirements
- Regulatory changes
- New technology
- Updated clinical practices
- New patient needs
Maintaining accreditation encourages organizations to continually review how their systems perform.
Why This Matters for Home Infusion
Home infusion introduces additional operational complexity because treatment occurs outside a traditional healthcare facility.
Safe, coordinated home infusion may involve:
- Pharmacy preparation
- Medication delivery
- Temperature control
- Supplies
- Infusion pumps
- Nursing
- Patient education
- Physician communication
- Monitoring
- Emergency procedures
ACHC maintains specific accreditation frameworks related to infusion pharmacy and home infusion therapy. (ACHC)
URAC likewise offers Infusion Pharmacy Accreditation for organizations that dispense infusion medications and provide services for patients receiving treatment at home or other ambulatory sites. (URAC)
These standards are particularly relevant to organizations providing specialty infusion care outside the hospital.
Accreditation Does Not Guarantee Outcomes
It is important to understand what accreditation does not mean.
URAC or ACHC accreditation does not guarantee:
- A medication will work
- Insurance will approve treatment
- A patient will experience no side effects
- Treatment will begin immediately
- Every patient will be appropriate for home infusion
- Financial assistance will be available
Healthcare outcomes depend on many individual variables.
Accreditation instead indicates that the organization has successfully completed an independent review against standards applicable to the accredited service.
Accreditation Is Different From Licensing
Pharmacy licensing and accreditation are not the same.
A pharmacy must meet applicable government licensing requirements.
Accreditation provides an additional external quality review.
URAC, for example, requires organizations applying for Specialty Pharmacy Accreditation to be licensed pharmacies in good standing. (URAC)
Patients can therefore think of accreditation as an additional quality framework layered on top of required licensing.
Why Accreditation Matters to Referring Physicians
Accreditation also matters to providers who refer patients for specialty therapy.
A physician needs confidence that the pharmacy can reliably coordinate:
- Prescription processing
- Medication access
- Prior authorization
- Patient communication
- Nursing
- Documentation
- Ongoing treatment
Physician offices already manage significant administrative workload.
Working with an accredited specialty pharmacy can provide another indicator that formal systems exist to support complex patient care.
Why Accreditation Matters to Insurers and Manufacturers
Specialty medications can be expensive and operationally complex.
As a result, health plans and pharmaceutical manufacturers often evaluate specialty pharmacies carefully.
URAC notes that many payers and manufacturers recognize pharmacy accreditation as independent validation of quality. (URAC)
This can make accreditation an important component of participating in certain specialty pharmacy networks or manufacturer relationships.
Why Mercy Continues to Maintain Both
For Mercy Pharmacy Group, maintaining both URAC and ACHC accreditation supports a broader philosophy:
Quality should be measurable, documented, reviewed, and continually improved.
Dual accreditation provides two independent perspectives on important areas of specialty pharmacy and infusion operations.
That external accountability helps reinforce Mercy’s focus on:
- Patient safety
- Reliable processes
- Pharmacy quality
- Clinical support
- Patient communication
- Operational consistency
- Continuous improvement
Questions Patients Should Ask Any Specialty Pharmacy
Accreditation is important, but it should be considered alongside other factors.
Patients may also want to ask:
Do you provide my medication?
Not every specialty pharmacy provides every treatment.
Can you help with prior authorization?
Specialty medications frequently require insurance approval.
Do you provide home infusion?
If home treatment is important to you, ask whether your therapy and location are supported.
Do you offer an infusion suite?
Some patients prefer treatment in a clinical environment.
Can you help identify financial assistance?
Manufacturer and foundation programs may be available for certain patients.
Can I speak with a pharmacist?
Patients should understand how to reach the clinical team when questions arise.
What happens if my insurance changes?
Long-term therapy may require new authorization when coverage changes.
Frequently Asked Questions About Dual Accreditation
Is Mercy Infusion accredited by both URAC and ACHC?
Yes. Mercy Infusion states that it maintains both URAC and ACHC accreditation. (Mercy Infusion)
Why would a pharmacy maintain two accreditations?
Different accrediting organizations provide distinct quality frameworks. Maintaining both gives an organization multiple external standards against which to evaluate its operations.
Does accreditation mean Mercy is automatically in my insurance network?
No. Accreditation and insurance-network participation are separate.
Does accreditation guarantee treatment approval?
No. Insurance companies make individual coverage and prior-authorization decisions.
Does accreditation mean treatment has no risks?
No medical therapy is risk-free.
Does accreditation apply to home infusion?
Both URAC and ACHC have accreditation programs related to infusion pharmacy and home infusion services. (URAC)
Quality Requires More Than a Certificate
Maintaining accreditation requires an ongoing commitment to structured processes, measurement, patient safety, and improvement.
For Mercy Pharmacy Group, maintaining both URAC and ACHC accreditation reinforces the standards behind the care patients experience every day.
Learn More About Mercy Infusion:
About the Author
April Cable is the Senior Director of Operations at Mercy Infusion, with more than 35 years of experience in specialty pharmacy billing, reimbursement, operations, and patient access. She works with patients, providers, insurers, pharmacists, and clinical teams to help coordinate specialty medication access and treatment.
Accreditation represents compliance with applicable standards established by the accrediting organization. Accreditation does not guarantee insurance approval, treatment eligibility, clinical outcomes, or financial assistance.
