Under the Patient Protection and Affordable Care Act, health insurance issuers offering qualified health plans in the Affordable Insurance Exchanges need to meet certain quality requirements. QHP issuers need to implement quality improvement strategies, enhance patient safety through specific contracting requirements and publicly report quality data.
In addition, HHS must take steps to ensure health plans in the Exchange market provide value, including developing a quality rating system.
CMS is seeking information on existing quality measures and quality reporting requirements that should be established for health plans in the Exchanges.
Specifically, CMS is seeking information on the following topics:
• Existing quality measures and rating systems for health plans
• Strategies and requirements for quality improvement
• Purchasing strategies to promote care redesign and patient safety
• Effective methodologies to measure health plan value
HHS plans to phase in quality reporting requirements for health plans. New quality reporting standards for qualified health plans in the Exchanges, except those related to accreditation, if applicable, will not go into effect until 2016.
Comments are due Dec. 27.
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