Health Insurance Marketplace Quality Initiatives. Spotlight News. CMS is hosting the 2. Quality Rating System (QRS) preview period beginning August 1. ET through August 2. ET. QHP issuers and Marketplace administrators will be able to review both the QRS preview reports and QRS proof sheets for their respective, QRS ratings- eligible reporting units in CMS’ Health Insurance Oversight System Marketplace Quality Module (HIOS- MQM) via https: //portal. During QRS preview, CMS also provided the 2. ![]() ![]() In this presentation you will learn about the enhancements and new capabilities of SAP HANA View Modeling. A specific focus targets Calculation View Modeling c SUMMARIES A summary takes the place of an objective statement when a candidate has relevant experience in the field to which they are applying. A summary is longer than an objective and highlights the. QRS Proof Sheet User Guide that includes more details regarding the 2. QRS rating methodology used to produce the QRS scores and ratings. The 2. 01. 6 QRS Proof Sheet User Guide contains mock data used to illustrate the QRS rating methodology. The 3. 0 day public comment period for the information collection requirements associated with the 2. QHP Enrollee Experience Survey is open until August 1. The QHP Survey information collection requirements can be found here: https: //www. CMS is releasing this Quality Rating Information Bulletin to announce that public reporting of quality rating information by the Federally- facilitated Marketplaces (FFMs), including FFMs where the State performs plan management functions, and State- based Marketplaces on the Federal Platform (SBM- FPs), will begin with the open enrollment period for the 2. In light of the 2. Bulletin also provides guidance for QHP issuers and for SBMs to generally continue to follow the QRS and QHP Enrollee Survey Technical Guidance for 2. CMS posts the HHS Notice of Benefit and Payment Parameters for 2. Final Rule in the Federal Register. CMS strengthens QHP issuer patient safety standards to better align with current, effective patient safety interventions, beginning on or after Jan. The Final Rule can be found at https: //www. CMS posts the Quality Improvement Strategy: Technical Guidance and User Guide for the 2. Coverage Year and the Quality Improvement Strategy Implementation Plan and Progress Report form and the issue brief describing these 2. An eligible issuer participating in a Marketplace for two or more consecutive years must implement and report on at least one quality improvement strategy (QIS). Beginning in 2. 01.
![]() QIS Implementation Plan and Progress Report form to report on their quality improvement strategies. The QIS Technical Guidance provides comprehensive background information about the QIS requirements, as well as step- by- step instructions for how to comply with the QIS requirements. Issuers with questions about the QIS requirements should contact the Exchange Operations Support Center (XOSC) Help Desk and reference the Marketplace Quality Initiatives- QIS or . Marketplaces are required to publicly report information on costs, coverage, quality ratings, and enrollee experience for each Qualified Health Plan (QHP) offered. Enrollee experience data will be collected through the 2. QHP Enrollee Survey. QHP Enrollee Survey Vendor Participation. The QHP Enrollee Survey will be administered by HHS- approved QHP Enrollee Survey vendors using a standardized mixed- mode survey with mail, telephone, and web survey protocols to facilitate comparison of QHPs both within and across Marketplaces. The survey will be conducted in three languages: English, Spanish and optionally in Chinese. It is estimated that the survey will include approximately 4. QHP- based units, with a target of 3. Approved survey vendors will draw a random sample based on a sampling frame provided by each QHP issuer and validated by an independent third party. The QHP Enrollee Survey is based on the CAHPS. The 2. 01. 7 survey will contain approximately 9. Instructions. To administer the 2. QHP Enrollee Survey, prospective survey vendors must submit a Participation Form for consideration of approval by CMS. Survey vendors must achieve all of the following to be considered an HHS- approved QHP Enrollee Survey vendor: Meet the 2. QHP Enrollee Survey Minimum Business Requirements (MBR). Comply with the protocols and requirements in the 2. Qualified Health Plan Enrollee Experience Survey. Quality Assurance Guidelines & Technical Specifications. Submit a curriculum vitae (CV) for all identified key project staff, both survey vendor and subcontractor(s), to the Project Team at qhpcahps@air. Successfully complete 2. QHP Enrollee Survey Vendor Training. The MBR and the Participation Form with instructions will be available on the QHP Enrollee Survey website, http: //qhpcahps. June 3. 0, 2. 01. Prospective survey vendors must submit a Participation Form and all related participation materials through the QHP Enrollee Survey website on behalf of their organizations for consideration of conditional approval by July 1. Questions should be directed to the following Technical Assistance e- mail address: QHP Enrollee Survey Project Team E- mail: qhpcahps@air. Telephone: 8. 44- 8. Project Website: http: //qhpcahps. About the Marketplace Quality Initiatives. The Affordable Care Act authorizes the creation of Health Insurance Marketplaces (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 Marketplaces. 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. HHS intends a phased approach to public reporting of QHP- specific quality information. 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: Quality Rating System (QRS)About the QRSSection 1. 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. Data Collection Guidelines. Documents describing the QRS requirements, technical specifications, and the QRS measures are available in the Downloads section at the bottom of this page. It also requires public display of information by each Marketplace to allow individuals to assess enrollee experience among comparable plans. Sections 1. 31. 3 and 1. Affordable Care Act provide the Secretary with general authority to establish standards and regulations related to Marketplaces and QHPs. CMS developed two consumer experience surveys to assess consumers’ and enrollees’ experiences with the Marketplaces and QHPs. Both surveys underwent preliminary testing in 2. The Guide suggests seven strategies that Marketplaces could implement and is available at: https: //qhpcahps. Technical Assistance Related to the Marketplace Survey. Through CMS funding, American Institutes for Research (AIR) is providing technical assistance to support Marketplaces in understanding, interpreting, and using the results of the survey. Expert Usability Testing. Conducted during the 2. State- Based Marketplace websites adopted principles for making a website usable for consumers and whether information about determining eligibility, comparing and choosing a health plan, and enrollment was easy to find. Results from this assessment are available in the Downloads section at the bottom of this page: Consumer Usability Testing. Conducted during the 2. State- Based Marketplace websites. This report describes the key challenges and best practice recommendations identified during the consumer website usability testing. Results from this assessment are available in the Downloads section at the bottom of this page: Issue Briefs. Issue briefs on the following topics are available in the Downloads section at the bottom of this page: Webinars. For QHP Issuers: For Marketplaces: Qualified Health Plan Enrollee Experience Survey. The Qualified Health Plan Enrollee Experience Survey (QHP Enrollee Survey) is intended to obtain enrollees’ perspectives on the services provided by QHPs offered through the Marketplaces. For copies of the current survey in English, Spanish, and Chinese in the 2. QHP Enrollee Survey item in the Downloads section at the bottom of this page: QHP Enrollee Survey 2. Test (English) QHP Enrollee Survey 2. Test (Spanish) QHP Enrollee Survey 2. Test (Chinese) Technical Assistance related to the QHP Enrollee Survey. More information about the survey questionnaire, measures, and technical assistance for participating survey vendors is available at: http: //qhpcahps. Reports for Issuers and Marketplaces for the QHP Enrollee Survey. QHP Enrollee Survey reports will be available later in 2. Quality Improvement Strategy (QIS)About the QISAn issuer participating in a Marketplace for two or more consecutive years must implement and report on a quality improvement strategy (QIS), in accordance with section 1. Affordable Care Act entitled “Rewarding Quality Through Market- Based Incentives”. The QIS requirements apply to all issuers offering QHPs and MSP options, whether through the individual market or through the Small Business Health Options Program (SHOP). A QIS is described in section 1. The standards for the QIS align with the National Quality Strategy, the CMS Quality Strategy, and other Federal, state and private sector quality improvement initiatives, where possible, to help reinforce national health care quality priorities.
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