QRS

About the Quality Rating System (QRS)

Section 1311(c)(3) of the Affordable Care Act directs the HHS Secretary to develop a system that rates QHPs based on relative quality and price. It also requires Marketplaces to display QHP quality ratings on Marketplace websites to assist in consumer selection of QHPs. Based on this authority, CMS established standards and requirements related to QHP issuer data collection and public reporting of quality rating information in every Marketplace. QHP issuers must submit quality rating information (specifically QRS clinical measure data and QHP Enrollee Response data) for its QHPs in accordance with CMS guidelines as a condition of certification and participation in the Marketplaces.

QRS Display

In 2017, 2018, and 2019, CMS displayed QRS star ratings on HealthCare.gov in select Federally-facilitated Exchange (FFE) states as part of a limited, phase-in pilot
program. Additionally, numerous State-based Exchanges (SBEs) elected to display QRS star ratings on their state websites.

As of 2020, quality rating information will be publicly displayed by all Exchanges, including the FFEs, inclusive of FFE states where the state performs plan management functions and State-based Exchanges on the Federal Platform (SBE-FPs), and State-based Exchanges (SBEs) that do not use HealthCare.gov. More information on the display of quality ratings can be found at
https://www.healthcare.gov/quality-ratings/. 

Page Last Modified:
01/16/2020 10:25 AM