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AHA comments on quality measures for insurance exchanges

January 2, 2013

Quality measures for health plans participating in exchanges should align with those in existing federal health care programs, AHA told the Centers for Medicare & Medicaid Services last week. Responding to the agency's public request for information on health care quality for exchanges, AHA urged CMS to implement strategies that encourage alignment and reduce the burden of measurement and reporting on hospitals. AHA also urged CMS to provide clear and transparent processes for hospitals to submit quality data to the plans, compare performance against benchmarks, and verify the accuracy of data used in public reporting. In addition, AHA said CMS' quality rating system for the plans should balance measures that assess hospital and provider quality with measures that assess health plan quality, including the ability to link patients to services. The Patient Protection and Affordable Care Act requires health plans participating in exchanges to collect and publicly report quality data, and CMS to develop a quality rating system for the plans.