Health Plan

URAC is one of the world’s fastest growing health care accreditation organizations. Today, more than 80 million Americans are covered by URAC-accredited health plans. Yet, even as it expands, URAC maintains the ability to be nimble and quickly adapt its programs to meet the challenges of today’s rapidly evolving health care landscape. This ability to change and grow with the times is aptly reflected in URAC’s Health Plan Accreditation with measures, which fully addresses the core requirements of the Affordable Care Act of 2010 (ACA), including nationally vetted performance measures. This program remains flexible by allowing organizations to add in any supplemental state-required health plan standards and measures.

URAC’s Health Plan Accreditation program with measures incorporates key market trends, addresses relevant policy issues, and aligns with the nine components for accrediting health plans as outlined in the ACA Section 1311 requirements for state exchanges: consumer access, utilization management, quality assurance, provider credentialing, complaints and appeals, network adequacy and access, patient information programs, measures, and the Consumer Assessment of Health Providers & Systems (CAHPS) Survey.

URAC’s Health Plan Accreditation standards address key issues stated in the ACA requirements, focusing on quality improvement activities that promote patient safety across the continuum of care:

  • Wellness and health promotion
  • Care coordination
  • Medication safety and care compliance
  • Reward quality
  • Care delivery through a patient centered medical home network
  • Mental health parity
  • Health Insurance Portability and Accountability Act  breach requirements
  • Measures – patient centeredness, coordination of care, patient safety, health plan administration
  • Effectiveness of care, and health information technology integration
  • Patient experience of care (CAHPS Survey)

Learn How URAC’s Health Plan Accreditation Helps Consumers Decide in Which Plan to Enroll

Learn Why Measuring Health Plan Quality and Performance is So Important




URAC Releases Standards for Patient Centered Medical Home Certification
Wednesday, February 22nd, 2017

National Quality Forum Selects URAC to Participate in National Quality Partners Leadership Consortium
Tuesday, January 24th, 2017

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