QIS

About Quality Improvement Strategy (QIS)

A QIS is described in section 1311(g)(1) of the Patient Protection and Affordable Care Act (PPACA), as a payment structure that provides increased reimbursement or other incentives to improve health outcomes, reduce hospital readmissions, improve patient safety and reduce medical errors, implement wellness and health promotion activities, and/or reduce health and health care disparities. The QIS standards align with the CMS Quality Strategy and other federal, State, and private sector quality improvement initiatives, where possible, to help reinforce national health care quality priorities.

• Documents describing the Quality Improvement Strategy (QIS) requirements and technical guidelines are available in the Downloads section at the top of this page. Answers to frequently asked questions related to QIS can be found on CCIIO’s Qualified Health Plan (QHP) Certification website under “FAQs” and “Marketplace Quality Initiatives FAQs” --> “Quality Improvement Strategy.”

Guidance

The Quality Improvement Strategy (QIS) materials for the 2024 Plan Year are now available for issuers to download on the Downloads page.

• The QIS Issuer List for the 2024 Plan Year includes issuers operating in Federally-facilitated Exchanges (FFEs) and FFEs where States perform plan management that meet the QIS participation criteria and are required to implement and report on at least one QIS as a condition of Qualified Health Plan (QHP) certification for the 2024 Plan Year.

• The QIS Implementation Plan form, Progress Report form, and Modification Summary Supplement form for the 2024 Plan Year (QIS forms) collect QIS information from issuers in order to demonstrate compliance with section 1311(c)(1)(E) of the Patient Protection and Affordable Care Act.

• The QIS Technical Guidance and User Guide for the 2024 Plan Year communicates finalized QIS requirements and instructions for how to complete the QIS form. 

Issuers should submit questions about QIS to CMS' Marketplace Service Desk (MSD) by phone at 1-855-CMS-1515 (1-855-267-1515) or by email at CMS_FEPS@cms.hhs.gov. When submitting inquiries via email, please include "MQI-QIS" and your HIOS Issuer ID in the subject line or body of the email.