Which accreditation requires a directory with criteria including Quality of Care, Service, and business need?

Which accreditation requires a directory with criteria including Quality of Care, Service, and business need?

• A. URAC
• B. NCQA
• C. TJC
• D. CMS

Answer: (A)

URAC focuses on health plan and provider network quality, including how a provider directory is built and used. Their standards require a provider directory that clearly documents which providers are included and why, using criteria such as quality of care, the level of service, and the business need for inclusion in the network. This ensures the directory reflects providers who meet defined quality and service expectations and that their inclusion supports the plan’s objectives and patient access. Other accrediting bodies have different foci—NCQA emphasizes quality measures and patient experience, The Joint Commission concentrates on safety and care processes in facilities, and CMS governs participation rules and reimbursement rather than accrediting provider directories. So the requirement for a directory with criteria around quality of care, service, and business need aligns with URAC's accreditation standards.

URAC focuses on health plan and provider network quality, including how a provider directory is built and used. Their standards require a provider directory that clearly documents which providers are included and why, using criteria such as quality of care, the level of service, and the business need for inclusion in the network. This ensures the directory reflects providers who meet defined quality and service expectations and that their inclusion supports the plan’s objectives and patient access.

Other accrediting bodies have different foci—NCQA emphasizes quality measures and patient experience, The Joint Commission concentrates on safety and care processes in facilities, and CMS governs participation rules and reimbursement rather than accrediting provider directories. So the requirement for a directory with criteria around quality of care, service, and business need aligns with URAC's accreditation standards.