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URAC

URAC is a non-profit organization that helps promote health care quality through the accreditation of organizations involved in medical care services.

According to the “About URAC” page that can be found on the organization’s website:

For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking products that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care.

URAC accredits health care organizations -- including health plans ( HMOs, PPOs, etc.), health care management organizations ( disease management, case management, patient centered medical homes, health call centers, independent review organizations, etc.), health websites, and telehealth.

The organization’s means of recognizing that an applicant qualifies for an accreditation of their services begins with a “desktop review” of the applicant’s policies and procedures. Documents are uploaded to an on-line web portal and later examined by a reviewer to establish that they meet URAC’s standards. This is followed by an on-site or virtual visit by a URAC reviewer to the applicant’s facilities to verify that actual operations match stated policies and procedures. When these reviews are completed, an independent accreditation committee considers the reviewer’s analysis of an organization in a “blinded” manner to determine whether or not to award an organization URAC accreditation.

URAC accreditation is given to an organization for a period of up to three years. An organization must go through a review again after this period expires in order to maintain their accredited status.

It is noted that “[t]he amount of time it takes for an organization to prepare an application… may vary depending on whether the appropriate work processes, policies, and procedures are in place” and “the type of accreditation you are seeking.” The website states that it “usually takes four to six months to complete an accreditation review once URAC receives your completed application.”

Accreditation standards for URAC programs are developed by independent experts, relying on advisory committees of experts in health care delivery. After internal discussion, the organization makes them available for public comment, refines them further based on comments, then passes them to URAC's independent advisory group for approval. URAC's board of directors gives final approval of accreditation standards.

Founded under the name Utilization Review Accreditation Commission in 1990, the name “was shortened to the acronym URAC in 1996 when it began accrediting other types of organizations such as health plans, pharmacies, and provider organizations.”

As of January 2016, the URAC website listed that it offered the following accreditation programs:

  • Accountable Care Accreditation
  • Case Management
  • Clinical Integration Accreditation
  • Community Pharmacy
  • Comprehensive Wellness
  • Credentials Verification Organization
  • Dental Network
  • Disease Management
  • Drug Therapy Management
  • Health Call Center
  • Health Content Provider
  • Health Network
  • Health Plan
  • Health Plan with Health Insurance Marketplace
  • Health Plan Quality Measures
  • Health Website
  • Health Utilization Management
  • Independent Review Organization
  • Mail Service Pharmacy
  • Medicare Advantage
  • Patient Centered Medical Home
  • Pharmacy Benefit Management
  • Provider Credentialing
  • Specialty Pharmacy
  • Telehealth
  • Transitions of Care Designation
  • Workers’ Compensation Property and Casualty Pharmacy Benefit Management
  • Workers’ Compensation Utilization Management

Educational programs include workshops, conferences, webinars and audio conferences open to individuals and companies in the health care industry. These programs cover best practices in URAC accreditation, and news on issues in health care presented by industry professionals and URAC staff.