Estimated read time: 4 minutes

The Decision That Keeps You Up at Night

You're staring at two accreditation paths, and honestly? The choice feels overwhelming. NCQA or URAC—both are nationally recognized, both emphasize quality improvement, and both offer those gold-star credentials your stakeholders are asking about.

But here's the thing: this isn't just a checkbox decision. It's a strategic choice that will impact your compliance workload, your market positioning, and frankly, your team's sanity for years to come.

You're Not Alone in This Confusion

At MHR, we hear this question often. Organizations get caught in analysis paralysis, comparing endless feature lists and trying to decode which accreditation body will be the "easier" path. (Spoiler alert: neither is easy, but one might be a better fit for your specific situation.)

The truth is, both NCQA and URAC offer structured standards frameworks and emphasize continuous quality improvement. Many key accreditations—like Health Plan, Utilization Management, and Case Management—are available from both organizations. Each has earned its stripes in the industry. But the differences? They absolutely matter.

Here's How to Cut Through the Noise

Let's break down what actually distinguishes these two accreditation bodies, so you can make a decision based on facts, not guesswork.

Key Differences

When URAC Makes Sense for You

Consider URAC if any of these sound like your organization:

•  Your organization is a digital health company, PBM, Dental Plan, or Specialty Pharmacy;
•  You need something NCQA doesn't offer such as accreditation in Health Contact Centers, Health AI, or other emerging fields;
•  You're breaking new ground and want to demonstrate operational excellence;
•  Commercial payers are your audience and you need credentials that pharmacy or telehealth buyers specifically recognize.

When NCQA Is Your Better Bet

NCQA likely fits better if:

•  Your organization is a health plan, specialty organization, provider group, or behavioral health organization. The smaller products are services that health plans typically delegate to other groups;
•  State Medicaid or Exchange program recognition is mission-critical;
•  You're already doing the work to meet HEDIS/QI measurement requirements for state compliance and you want an accreditation that aligns.

Get Our Free Tool: Comparison of URAC and NCQA Accreditations 

https://www.managedhealthcareresources.com/ncqa-v-urac-comparison-tool 

Plot Twist: You Don't Have to Pick Just One

Here's something many organizations don't realize—your accreditation strategy doesn't have to be all-NCQA or all-URAC. You can mix and match based on your specific offerings, organizational structure, and state mandates.

For example, a health plan may be accredited by URAC but there is a state mandate for Utilization Management to be accredited by NCQA, or vice versa.

Ready to Get Started?

Whether you choose NCQA, URAC, or a combination approach, the key is moving forward with confidence and the right guidance.

Join us for our complimentary webinar: Key Differences Between NCQA and URAC Accreditations

When: October 30, 1-2pm ET
Price: FREE
Register Here: https://www.managedhealthcareresources.com/Oct30-webinar 

Ready to begin your accreditation journey? Learn more about how MHR can help guide your decision with clarity and confidence. https://www.managedhealthcareresources.com/urac-consulting-services 

At MHR, we've been helping organizations navigate both NCQA and URAC accreditations for over three decades. Our team includes current NCQA surveyors and former URAC surveyors who understand both systems inside and out.