CMS’s Health Insurance Exchange Quality Rating System (Aug. 2021)
the Patient Protection and Affordable Care Act (PPACA) directs the U.S. Department of Health & Human Services (HHS) Secretary to develop a system that rates qualified health plans (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.
QHP issuers must submit quality rating information (specifically QRS clinical measure data and QHP Enrollee Survey response data) for its QHPs in accordance with CMS guidelines as a condition of certification and participation in the Marketplaces.
The following documentation is listed
- 2021 Quality Rating System Proof Sheet User Guide (PDF)
- Quality Rating System and Qualified Health Plan Enrollee Experience Survey: Technical Guidance for 2021 (PDF)
- 2021 Quality Rating System Measure Technical Specifications (PDF)
- 2021 Quality Rating System and QHP Enrollee Experience Survey: Operational Instructions (PDF)
- Health Insurance Exchange Quality Rating System 101
- Choosing a High-Quality Marketplace Plan
- Health Insurance Exchange Quality Rating System 101