URAC Health Plan Map of the USA

3 easy steps to begin your URAC accreditation

Obtain the standards at the URAC store
Request a consultation
Sign the application agreement for accreditation
Sign the application agreement for accreditation

URAC offers health plan accreditation in all states and territories

And there are 13 states where URAC fulfills state requirements for health plan accreditation: Connecticut, Florida, Iowa, Michigan, Minnesota, Montana, North Dakota, New Jersey, New Mexico, Nevada, Texas, Utah, Vermont.

Better Prepared

At URAC, the Health Plan Accreditation process is more than collecting metrics and box checking. Only URAC offers you extensive industry knowledge through a comprehensive program that creates the structure to drive efficiencies and outcomes in today’s value-based model of health care.

URAC offers you the same Health Plan Accreditation prized by larger organizations at a highly affordable price. URAC aims to reduce the financial barrier to entry so that smaller health plans earn recognition for their quality improvement activities, position themselves and demonstrate their value in caring for their membership, delivering the highest outcomes. URAC accreditation helps to improve the quality of health care delivered by health plans of all sizes.

Participation Criteria

URAC welcomes a conversation to discuss your organization and special pricing, which involve criteria such as number of covered lives.

Short- And Long-Term Benefits

Every part of a health plan’s organization that touches a member or provider performs better when driven by URAC standards. Earning the prestigious Health Plan Accreditation from URAC brings a plan-wide quality management framework along with numerous benefits:

  • Assure government regulators and providers that your organization meets rigorous standards and measures of operational integrity
  • Elevate contracting power and increase revenue by supporting performance-based measures and outcomes
  • Improve member satisfaction and loyalty through services to identify trends and opportunities for improvement, as well as ensure clear communication about benefit plans, coverage, provider availability, protections and more
  • Become a lean, smarter and more effective organization by streamlining quality management processes and improving regulatory compliance based on proven outcomes
  • Enhance provider satisfaction through programming that documents and optimizes orientation, fee-schedule changes, dispute resolution mechanisms, clinical practice guidelines, clinical review criteria and other essential activities
  • Deliver risk management peace-of-mind with standards that prevent, protect and manage liabilities, including patient safety, patient health and drug utilization management

Performance Measures

We meet you where you are when it comes to standardized measures, particularly those related to clinical performance and member satisfaction. Our flexible process is compatible with any measures you have in place or are required to report, including CAHPS® and HEDIS®.

Quality Improvement Activities

The Health Plan Accreditation program gives you access to a team of specialty experts who provide an impartial evaluation of your health plan to ensure compliance with industry benchmarks and best practices in all areas of management, including:

  • Risk management and regulatory compliance
  • Mental health parity
  • Quality management
  • Privacy and security of member information
  • Network management
  • Provider credentialing
  • Member services and communications
  • Utilization management
  • Population health management
  • HIPAA Breach Requirements

Download our Health Plan Standards-at-a-Glance.

Related Accreditations

What to Expect

In six months or less, URAC will collaborate with your team to create a flexible framework for continuous improvement without prescribing how to meet those standards. URAC’s approach stimulates innovation across the continuum of care through email, conference calls and web conferencing.

Who May Apply

Health plans, including commercial plans such as health maintenance organizations, preferred provider organization, self-insured and Medicaid plans, are eligible to apply.