URAC, an independent, nonprofit organization, is a well-known leader in promoting health care quality through its accreditation, education, and measurement programs. URAC offers a wide range of quality benchmarking programs and services that model the rapid changes in the health care system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry.
In the late 1980′s, concerns grew over the lack of uniform standards for utilization review (UR) services. UR is the process where organizations determine whether health care is medically necessary for a patient or an insured individual. As a result, URAC’s first mission was to improve the quality and accountability of health care organizations using UR programs. In later years, URAC’s mission expanded to cover a larger range of service functions found in various health care settings, including the accreditation of integrated systems such as health plans to smaller organizations offering specialty services. Formally incorporated in 1990, URAC has more than 30 accreditation and certification programs.
From conception, URAC’s founders recognized that an accreditation organization would not be accepted by regulators, health care providers, and consumers if controlled by industry interests. Therefore, several operating principles were incorporated into URAC’s structure and bylaws. First, URAC was set up as an organization independent of any particular stakeholder group. Second, the governing board of directors was established with representatives from all affected constituencies: consumers, providers, employers, regulators, and industry experts.
URAC is one of the fastest growing health care accreditation agencies in the world. It will continue to develop new standards for the health care system and revise existing ones to promote national standards and to ensure that all stakeholders, including consumers and providers, are protected.