Life Health Pro announced the Federal Government’s “request for information” (RQI) about how the quality of the health plans should be measured in the upcoming health insurance exchanges that are to start in January 2014. The official announcement for the RQI commences on November 27, 2012 with a notice in the Federal Register (full request found at the Federal Register site). The government allots a 30 day feedback period for the public to respond to the RQI.
The Centers for Medicare and Medicaid Services (CMS) divided up the request for information into fifteen sets of questions the government seeks input about the quality of Obamacare Exchange Insurance plans. Below illustrates but a few of the questions:
- What quality indicators do insurance companies currently use such as improving outcomes or preventing medical errors?
- What are challenges to reporting of quality metrics and what solutions exist?
- As a consumer, what current process do you obtain reports from such as on websites or mail outs from facilities or insurance companies?
- How do healthcare insurance companies monitor such activities as coordination of care, discharge planning or deaths?
- What approaches can be used to further the goals of the National Quality Strategy (Aims of better care, healthier people and affordable care) using the reporting requirements of Obamacare Exchange Insurance plans?
- What current quality measurements or measure sets used by the States or CMS are most pertinent to the new Obamacare Exchange Insurance?
- Do any gaps exist in the clinical measurement sets presently used?
- How might a new Exchange appraise the value of quality measurement approaches across plans and issuers?
- What approaches can be deployed to obtain and present performance improvement activities?
- What quality ratings should take priority in the Obamacare Exchange Insurance plans? (Should it be similar to the Medicare Advantage priorities of staying healthy with screenings, tests and vaccines; managing chronic conditions; rating health plan responsiveness and care or health plan complaints?)
- What ways to display quality rating would be valuable for consumers and small employers (that come to mind as you review public reporting that insurance and healthcare entities use now)?
- What challenges exist for reporting of insurance quality data to the public especially in regard to presenting numbers and facts?
- Describe any approaches the state health departments are planning to use to compare quality reporting between commercial plans and Obamacare Exchange Insurance plans?
- Are any approaches planned that will track the quality and effect of the services on individuals with disability or communication barriers?
- What factors should the Department of Health and Human Services consider to calculate health plan value that would be meaningful to consumers?
The Centers for Medicare and Medicaid Services sent the request to the Federal Register so the public can address these questions and voice their comments in one of four ways. The public can respond electronically to http://www.regulations.gov, or by regular mail to Centers for Medicare and Medicaid Services, Department of Health and Human Services, Attention: CMS-9962-NC, P.O. Box 8010, Baltimore, M.D., 21244-8010, or by express mail to Centers for Medicare and Medicaid Services, Department of Health and Human Services, Attention: CMS-9962-NC, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, M.D. 21244-1850, or written comments to Centers for Medicare and Medicaid Services, Department of Health and Human Services, Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. 20201.
By commenting, you voice your right to free speech and contribute to improving the quality of our country’s health care. CMS posts all comments received in a timely manner before the December 27, 2012 deadline at their website: http://www.regulations.gov.