About the Marketplace Quality Initiatives
The Affordable Care Act authorizes the creation of Health Insurance Exchanges (Exchanges) (also known as Health Insurance Marketplaces) to help individuals and small employers shop for, select, and enroll in high quality, affordable private health plans. Only qualified health plans (QHPs) may be offered within the Exchanges.
The Affordable Care Act requires the U.S. Department of Health & Human Services (HHS) to develop quality data collection and reporting tools and set QHP quality-related certification standards such as a Quality Rating System (QRS), a Quality Improvement Strategy (QIS), an enrollee satisfaction survey system and patient safety standards. Health care quality information will inform consumer selection of a QHP, decisions about QHP certification, and the Federal and State Exchanges’ monitoring of QHP performance. HHS anticipates a phased approach to public reporting of QHP-specific quality information.
The following final regulations established the quality reporting standards related to the Marketplace Quality Initiatives:
- Quality Rating System and Enrollee satisfaction survey system standards (including standards for application and approval of survey vendors)
- Quality Improvement Strategy standards
- Patient safety standards
Webinar slides describing the Marketplace Quality Initiatives, including the QRS, consumer experience surveys, the QIS, and patient safety standards can be accessed in the Downloads section at the bottom of this page:
- Marketplace Quality Initiatives Update March 2016 (PPTX) – slides that provide an overview of the Marketplace Quality Initiatives consumer friendly information about choosing a high-quality health plan through the Health Insurance Exchange is available here and other consumer-friendly information about new coverage options is available at www.HealthCare.gov.
For more information and guidance for QHP issuers and States, you may visit the Center for Consumer Information and Insurance Oversight (CCIIO) website.