What URAC does

URAC is an independent nonprofit health care accreditation organization founded in 1990 and headquartered in Washington, DC. It develops and administers 47 accreditation and certification programs across pharmacy, health plan, patient care management, telehealth/digital health, and administrative management categories, serving nearly 1,100 organizations that include major national payers, pharmacy chains, hospitals, and digital health providers. URAC's portfolio spans specialty and mail-service pharmacy, Medicaid and Medicare Advantage health plans, telehealth, case and utilization management, mental health parity, opioid stewardship, and a 2025-launched Health Care AI Accreditation program. Three-year accreditation cycles with annual measures submission and ongoing monitoring produce recurring revenue, complemented by separately contracted URAC-approved data validation services and trademarked branded programs such as Pharmacy Quality Management and Mental Health at Work.

URAC's underlying technology is built around AccreditNet, a proprietary web-based platform where applicants upload documentation and demonstrate compliance through Desktop Review sections, and the URAC Measures Tool, a secure portal for annual performance measure submission during a fixed July 1–September 30 window. ParityManager software supports mental health parity compliance by evaluating quantitative and non-quantitative treatment limitations against regulatory requirements, and the copyrighted Pharmacy Information Systems Capability Assessment (ISCA) form captures data quality controls during measurement validation. Standards are developed collaboratively with industry experts, advisory groups, and public comment periods, and are aligned with payer and federal regulator priorities.

URAC generates revenue primarily through application fees, annual program fees, and renewal fees on a subscription billing cadence, with fee levels varying by program, size of business, and number of sites. Distribution is sales-led through business development executives who route organizations to assigned Client Relations Managers as a single point of contact. Customer segments include healthcare providers and payers (hospitals, health systems, health plans, FQHCs, case management organizations, IROs), digital health organizations (telehealth, telemedicine, remote patient monitoring), care management organizations, and international healthcare organizations, with international telehealth accreditation recognized by the Dubai Health Authority.

Name

URAC

Legal name

URAC

Website

https://urac.org

Company type

Private

Founded year

1990

Operating status

Operating

Headcount range

101–250 employees

Short description

URAC is an independent nonprofit health care accreditation organization founded in 1990, offering 47 accreditation and certification programs to nearly 1,100 organizations across pharmacy, health plans, telehealth, digital health, and care management.

Ownership category

akta.pro rank

Product category

Healthcare Accreditation Services

SIC

Services-Health Services (8000)

akta.pro primary industry

Online/Distance Education Quality & Accreditation Bodies (EDADACAK)

Keywords

• Healthcare accreditation
• Certification programs
• Quality standards
• Regulatory compliance
• Independent accreditation

Headquarters

HQ city

Washington

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Accreditation and Certification Fees: URAC generates revenue through accreditation and certification fees charged to healthcare organizations seeking recognition. Fee structure varies by program type and is based on factors such as size of business and number of sites. Organizations pay application fees, annual fees during the three-year accreditation cycle, and fees for data validation services.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels7 records

Core offering

URAC is an independent nonprofit healthcare accreditation organization that develops standards and provides accreditation, certification, and designation programs for healthcare organizations. It serves nearly 1,100 organizations across 47 programs spanning pharmacy, health plans, patient care management, digital/telehealth, and administrative management. Its portfolio includes the nation's first Health Care AI Accreditation, Mental Health at Work Accreditation, and Excellent Health Outcomes Accreditation, with supporting proprietary platforms including AccreditNet, the URAC Measures Tool, and ParityManager software.

Product overview

URAC is an independent nonprofit health care accreditor offering a comprehensive portfolio of accreditation programs, certifications, and designations for health care organizations. The portfolio spans multiple categories including: Pharmacy (Specialty Pharmacy, Mail Service Pharmacy, Infusion Pharmacy, Pharmacy Benefit Management, Opioid Stewardship, Rare Disease); Health Plans (Health Plan, Medicaid, Medicare Advantage, Marketplace, Dental Plan); Patient Care Management (Utilization Management, Case Management, Telehealth, Disease Management); Administrative Management (Health Networks, Credentialing, Community Health Workers); Digital Health (Health Website, Telehealth, Measurement-Based Care, Remote Patient Monitoring); and specialized programs for AI, Mental Health Parity, Mental Health at Work, and Health Outcomes. Supporting technology platforms include AccreditNet (proprietary web-based accreditation management), the URAC Measures Tool (performance data submission), and ParityManager Software (mental health parity compliance). URAC also runs the Leaders in Performance Measurement awards program recognizing excellence among accredited organizations.

Differentiator

Problem solved

Functional benefit

Brands

• Health Care AI Accreditation: First-of-its-kind accreditation program for health care organizations and AI developers demonstrating responsible AI governance and oversight
• Mental Health at Work Accreditation
• Excellent Health Outcomes Accreditation
• ParityManager
• AccreditNet
• Pharmacy Quality Management

Products and services

• Specialty Pharmacy Accreditation Accreditation for organizations that dispense and distribute specialty medication and provide patient management services to patients taking specialty medications. Eligible for Rare Disease Certification.
• Mail Service Pharmacy Accreditation Accreditation for pharmacies that dispense and distribute traditional medications and/or supplies via mail.
• Pharmacy Services Accreditation Accreditation for organizations providing pharmacy-type services to patients, such as vaccine administration, point-of-care testing, drug therapy management, and community dispensing.
• Specialty Pharmacy Services Accreditation Accreditation for organizations providing patient management services for patients taking specialty medications.
• Pharmacy Benefit Management Accreditation Accreditation for organizations providing drug benefit coverage for members.
• Infusion Pharmacy Accreditation Accreditation for organizations that dispense infusion medications and provide infusion services to patients for administration in home or other ambulatory care sites.
• Medicare Home Infusion Therapy Supplier Accreditation Accreditation for organizations providing infusion services to Medicare patients for administration in the home.
• Health Care AI Accreditation Nation's first Health Care AI Accreditation providing independent validation of AI governance, oversight, and accountability practices for health care organizations and AI developers across the AI lifecycle.
• Mental Health at Work Accreditation Accreditation showcasing organizational commitment to employee mental health through workplace practices, systems, and policies. Anchored by the Mental Health at Work Index from One Mind at Work. Organizational, non-clinical, flexible and scalable, scored on a 1-4 scale.
• Excellent Health Outcomes Accreditation Formerly Health Equity Accreditation. Recognizes organizations working to reduce disparities, improve access, and achieve better health outcomes for populations they serve. Developed with US Office of Personnel Management, American Public Health Association, and Blue Cross Blue Shield Association.
• Health Plan Accreditation Accreditation for health plans performing and/or delegating coverage of designated health services for members.
• Medicaid Health Plan Accreditation Accreditation for health plans performing and/or delegating coverage of designated health services for Medicaid members.
• Medicare Advantage Organization Accreditation Accreditation for organizations performing and/or delegating the management of Medicare patients' care.
• Marketplace Health Plan Accreditation Accreditation for health plans performing and/or delegating coverage of designated health services through a Health Insurance Marketplace program.
• Dental Plan Accreditation Accreditation for organizations performing and/or delegating coverage of designated dental plan services for members.
• ParityManager Software Software solution for health plan parity compliance. Powers analysis for Mental Health Parity Accreditation by enabling organizations to upload plan data and policies, evaluate QTLs and NQTLs, identify gaps, and generate documentation for regulatory review.
• Mental Health Parity Accreditation Accreditation demonstrating compliance with mental health and substance use disorder parity requirements. Supported by ParityManager software for analyzing and documenting parity compliance.
• Health Utilization Management Accreditation Accreditation for organizations completing determination of medical necessity for medical and/or behavioral health clients, peer clinical review, and appeals as applicable.
• Case Management Accreditation Accreditation for organizations providing interactive care coordination in collaboration with patients and other stakeholders.
• Telehealth Accreditation Accreditation for organizations providing care via digital technology in patient-initiated or provider-initiated encounters.
• Workers' Compensation Utilization Management Accreditation Accreditation for organizations completing determination of medical necessity for injured workers, peer clinical reviews, and if applicable, appeals.
• Health Contact Center Accreditation Accreditation for organizations performing health triage and clinical support services or non-clinical support services for health care organizations.
• Disease Management Accreditation Accreditation for organizations managing a defined population with chronic disease(s) and/or co-morbidities.
• Independent Review Organization Accreditation Accreditation for organizations providing third-party medical review resource for objective, unbiased review decisions.
• Community Health Worker Program Accreditation Accreditation designed for organizations that use Community Health Workers, validating program infrastructure and commitment to community health.
• Clinically Integrated Network Accreditation Accreditation for organizations providing health services through a provider network that coordinates care across the continuum.
• Health Network Accreditation Accreditation for organizations performing and/or delegating health network functions, including management, credentialing and recredentialing.
• Credentials Verification Organization Accreditation Accreditation for organizations gathering information and verifying provider credentials to determine qualifications.
• Employer-Based Population Health Accreditation Accreditation for employer- and/or union-sponsored care delivery models that focus on population health and care coordination.
• Health Website Accreditation Accreditation providing independent third-party validation of an organization's health website, demonstrating commitment to providing high-quality health information and meeting high standards for information delivery.
• AccreditNet Platform URAC's proprietary web-based technology platform used by applicants to enter documentation, demonstrate compliance, and track accreditation progress through the Desktop Review sections.
• URAC Measures Tool Web-based portal for submitting annual performance measure data. Separate from AccreditNet, used during the measures submission period of July 1-September 30.
• URAC-Approved Data Validation Services Independent validation by URAC-approved third-party vendors (Advent Advisory Group, Attest Health Care Advisors, HealthcareData Company, MetaStar) to validate measure data accuracy before submission.
• URAC International Telehealth Accreditation International telehealth accreditation program recognized by Dubai Health Authority as a requirement to provide telehealth services. Includes Telehealth, Health Website, and Remote Patient Monitoring accreditation programs for international organizations.

Quantifiable outcome

• Nearly 1,100 healthcare organizations hold URAC accreditation
• +2 more outcomes

Named customers10 records

Segments5 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Eight partnerships are on record, tiered core and minor.

• International Society for Telemedicine and eHealth (ISfTeH)coreStrategic or Co-development PartnerURAC is a member of the ISfTeH, an international organization advancing telemedicine and eHealth. This membership supports URAC's international accreditation services and positions the organization at the forefront of global digital health transformation.
• Dubai Health AuthoritycoreStrategic or Co-development PartnerThe Dubai Health Authority has made Telehealth Accreditation a requirement to provide telehealth services in Dubai. URAC is recognized as an accreditation standard in the DHA Standards for Telehealth Handbook, providing URAC-accredited organizations preferential access to the Dubai market.
• Ain Shams University Virtual HospitalminorOthersInternational client in Egypt pursuing URAC telehealth accreditation as part of their digital health transformation.
• Glucare Integrated Diabetes CenterminorOthersDubai-based international client pursuing URAC accreditation to demonstrate commitment to quality patient care and meet evolving challenges in digital health.
• US Office of Personnel ManagementcoreStrategic or Co-development PartnerURAC developed Excellent Health Outcomes Accreditation standards in collaboration with US Office of Personnel Management, among other respected partners, to create comprehensive health equity standards.
• American Public Health AssociationcoreStrategic or Co-development PartnerURAC collaborated with American Public Health Association to develop Excellent Health Outcomes Accreditation standards focused on reducing disparities and improving health outcomes.
• Blue Cross Blue Shield AssociationcoreStrategic or Co-development PartnerURAC worked with Blue Cross Blue Shield Association to develop Excellent Health Outcomes Accreditation standards aligned with payer priorities for health equity and outcomes improvement.
• One Mind at WorkcoreStrategic or Co-development PartnerURAC's Mental Health at Work Accreditation is anchored by the cutting-edge Mental Health at Work Index from One Mind at Work, providing the framework for evaluating workplace mental health programs.

Scale indicators4 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• NCQA (National Committee for Quality Assurance): Leading accreditor of health plans, MCOs, and provider organizations. Direct competitor to URAC's Health Plan Accreditation portfolio and overlapping in utilization management credentials.
• The Joint Commission: The largest U.S. healthcare accreditor, focused on hospitals and health systems. Direct competitor to URAC across hospital, health system, and specialty program accreditation, with significantly larger scale.
• CARF International: Accreditor for rehabilitation, behavioral health, and human services organizations. Overlaps with URAC's patient care management and behavioral health programs.
• HFAP (Healthcare Facilities Accreditation Program): Hospital-focused accreditation program authorized by CMS. Competes with URAC for hospital and healthcare facility credentials and Medicare deemed-status surveys.
• ACHC (Accreditation Commission for Health Care): Healthcare accreditation body covering home health, hospice, infusion pharmacy, and specialty pharmacy. Overlaps directly with URAC on infusion pharmacy and durable medical equipment programs.
• NABP (National Association of Boards of Pharmacy): Issues pharmacy accreditations and credentials including VIPPS for pharmacy websites. Direct competitor to URAC on Mail Service Pharmacy and digital pharmacy programs.
• CHAP (Community Health Accreditation Partner): Accreditor focused on community-based healthcare providers, home infusion, and hospice. Direct competitor to URAC's community and home-care accreditation programs.
• AAAHC (Accreditation Association for Ambulatory Health Care): Accredits ambulatory and office-based surgery centers. Competes with URAC for outpatient and ambulatory care accreditation, with deep penetration in surgical settings.

Others

• Institute for Credentialing Excellence (ICE): Professional membership association that sets standards (NCCA) for credentialing programs across healthcare and other industries. Adjacent ecosystem peer rather than direct accreditation competitor.
• ISO (International Organization for Standardization): Develops ISO management system standards (9001, 27001, 13485) widely used in healthcare. Not a direct accreditor of healthcare organizations but a standards-based alternative influencing buyer choices.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key highlights7 records

Customer concentration

• Xx.com/URAC
• Facebookfacebook.com/urac.org
• LinkedInlinkedin.com/company/urac

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about URAC