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MAP Report Provides Input on Marketplace Quality Reporting System

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Summary

On Dec. 23, the Measure Applications Partnership (MAP), a public-private partnership tasked to provide HHS with pre-rulemaking input on measures included in federal programs, released a draft report offering guidance on the Qualified Health Plan (QHP) Quality Reporting System (QRS) for the Health Insurance Exchange Marketplaces proposed by CMS.
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The agency hopes that this information published in the Marketplace will guide consumers in navigating plan options available through the Marketplace, similar to “Star Ratings” for Part D and MA.

In their report, MAP supports most measures previously proposed by HHS for the QRS, suggesting only minor modifications to the structure. MAP recommends that QRS adapt additional cost-based measures that take into consideration the consumer perspective whenever possible. Given MAP’s estimate that the Marketplace population is 166 percent of the federal poverty level compared with the currently insured population (333 percent), out-of-pocket costs will likely be of most interest to consumers. Only one of the proposed QRS measures addresses health plan costs, thus requiring more measures to address the overall impact of plan costs on patients.

The quality information reported on the Marketplaces may help consumers in differentiating plans options if costs fail to do so. Evidence suggests that consumer use of quality rating information has traditionally been limited; however, this may change if costs are a major factor as predicted by MAP.

MAP will release a final report to HHS in the coming weeks, augmenting public feedback in response to HHS’ “Notice with Comment” released on Nov. 21 on the proposed QRS framework. While the comment period on the MAP report closed Jan. 6, the comment period for the HHS release closes on Jan. 21. HHS will release the final QHP rule with further technical guidance later in 2014. Public reporting for Exchange plans is expected to start in 2016.

Read the MAP draft report here.

The HHS release can be accessed here.

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