America’s Essential Hospitals submitted comments April 21 to the Centers for Medicare & Medicaid Services (CMS) on its proposed rule on health insurance marketplace (exchange) standards. In the proposed rule, CMS outlines standards for a quality rating system (QRS) used to assess the performance of qualified health plans in the marketplaces. In its comments, America’s Essential Hospitals noted that to be truly beneficial in protecting consumer access to quality health care, the QRS must go hand in hand with efforts to ensure essential community providers (ECPs) are included in marketplace plan networks. The association urged CMS to implement the QRS in a way that protects consumer access to ECPs, stating that CMS should include measures that reflect plan network composition, including a list of all providers in the plan, by provider type.
America’s Essential Hospitals also urged CMS to ensure the measures used in the QRS are endorsed by the National Quality Forum and are risk adjusted for socioeconomic factors to accurately reflect the quality of care provided.
Contact Shahid Zaman, JD, policy analyst, at firstname.lastname@example.org or 202.585.0124 with questions.