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Health Insurance Marketplace Quality Initiatives

Spotlight News

  • CMS has posted the Plan Year 2020 Nationwide Quality Rating System PUF (ZIP) which includes underlying measure data (i.e., measure rates and denominators) as well as star ratings for all eligible Qualified Health Plan (QHP) issuers, operating in all Exchange types, that received QRS star ratings for Plan Year 2020. CMS has also posted a Quality PUF (ZIP) that includes star ratings assigned to plans that will be available on HealthCare.gov for Plan Year 2020.  CMS has released the Health Insurance Exchanges QRS Program for Plan Year 2020: Results At-A-Glance (PDF),  which summarizes the QRS ratings for the 2020 Plan Year, including a summary of QRS reporting and QRS scoring eligibility for the 2020 Plan Year.
  • CMS has posted the Qualified Health Plan Enrollee Experience Survey: Technical Specifications for 2020. For additional information, please see the QHP Survey Page.

  • CMS has posted the Quality Rating System and Qualified Health Plan Enrollee Experience Survey: Technical Guidance for 2020 (PDF). QHP issuers certified to offer coverage through the Exchanges in 2020 are required to comply with QRS and QHP Enrollee Survey requirements as a condition of certification. QHP issuers with questions regarding the QRS or the QHP Enrollee Survey should contact the CMS Marketplace Service Desk (MSD) (CMS_FEPS@cms.hhs.gov) and reference the Marketplace Quality Initiatives or "MQI-QRS.”

  • CMS released the Quality Rating Information Bulletin (PDF) to announce that public display of quality rating information by all Exchanges, including Federally-facilitated Exchanges (FFE), inclusive of FFE states where the state performs plan management functions, State-based Exchanges on the Federal Platform (SBE-FPs), and State-based Exchanges (SBEs) that do not use HealthCare.gov will begin during the Open Enrollment Period (OEP) for the 2020 Plan Year.

  • CMS released the 2020 Quality Rating System and QHP Enrollee Experience Survey: Operational Instructions (PDF). This document serves as a resource for QHP issuers to review the QRS and QHP Enrollee Survey requirements.

QRS:

  • CMS has posted the Final 2019 Call Letter for the Quality Rating System and the Qualified Health Plan Enrollee Experience Survey (PDF) to communicate finalized refinements to the QRS and QHP Enrollee Survey programs for 2020 and beyond. This document also summarizes comments received on the Draft 2019 QRS Call Letter.
  • CMS has posted the 2020 Quality Rating System Measure Technical Specifications (PDF), which includes the measure specifications and guidelines for data collection for the 2020 QRS measure set. QHP issuers will need to reference this document in order to collect and submit QRS measure data to CMS in accordance with the QRS 2020 requirements. QHP issuers with questions regarding the QRS or the QHP Enrollee Survey should contact the Marketplace Service Desk (CMS_FEPS@cms.hhs.gov) and reference the Marketplace Quality Initiatives or "MQI-QRS."

  • CMS has posted the Plan Year 2019 Nationwide Quality Rating System PUF (ZIP) which includes underlying measure data (i.e., measure rates and denominators) as well as star ratings for all eligible Qualified Health Plan (QHP) issuers, operating in all Exchange types, that received QRS star ratings for Plan Year 2019. The nationwide QRS PUF is primarily intended for researchers, but may also be used by consumer groups, states or other entities. CMS intends to provide a similar nationwide QRS PUF on an annual basis and to promote transparency of data to the public. CMS has also posted the Health Insurance Exchanges QRS Program for Plan Year 2019: Results At-A-Glance (PDF), which summarizes the QRS ratings for the 2019 Plan Year, including a summary of QRS reporting and QRS scoring eligibility for the 2019 Plan Year.

QHP Survey:

  • CMS has posted the Qualified Health Plan Enrollee Experience Survey: Technical Specifications for 2020 and the templates for 2020 Survey Materials.

  • Please seek further information for the QHP Survey on the QHP Survey Page located here.

QIS:

Upcoming Deadlines and Events

 
QRS/QHP Enrollee Survey deadlines for issuers

QHP issuers, Marketplace administrators, and CMS preview the 2019 QHP quality rating information and QHP Enrollee Survey results.

August 2019

QRS and QHP Enrollee Survey Requirements webinar held via REGTAP

October 17, 2019
QIS deadlines

Future Dates TBD

TBD

Resources

Marketplace Quality Initiatives Listserv
We encourage you to let others know about the CMS Marketplace Quality Initiatives, and to share its messages. Subscribe to Marketplace Quality Initiatives Listserv to be included in future communications and updates.

 Marketplace Service Help Desk (MSD) (reference “Marketplace Quality Initiatives”):
CMS_FEPS@cms.hhs.gov or 1-855-CMS-1515 (1-855-267-1515)

Registration for Technical Assistance Portal (REGTAP)
http://REGTAP.info

Center for Consumer Information and Insurance Oversight (CCIIO) website:

/cciio/

 

Page Last Modified:
12/03/2019 03:11 PM