Health Information Management

News: CMS previews new Simple Choice Plans and quality ratings

CDI Strategies, May 12, 2016

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With the fourth year of open enrollment for Affordable Care Act (ACA) marketplace health plans just six months away, CMS is launching two new programs—Simple Choice Plans and the Quality Rating System— to help consumers make informed decisions about their health care, according to a blog post published by the organization on April 29.
Consumers enrolling in a new government health insurance plan with have the option to select “Simple Choice plans” —plans with a uniform set of features which allow the consumer to compare plans on a simplified list of factors, such as monthly premiums and providers in the plan’s network. This tool will accompany other tools, such as the physician and prescription drug lookup, to help consumers select the most appropriate plan for them.  
Also debuting for the 2017 enrollment period is the new Quality Rating System, which will rate health care services using a 5-star scale to inform consumers about the quality of healthcare services. The system will rank the quality of the health insurance plan based on a number of factors, including how well physicians coordinate with patients and how other patients rate their doctors and the care they receive. CMS will display these ratings on during the open enrollment period.
The quality ratings will pilot in Michigan, Ohio, Pennsylvania, Virginia, and Wisconsin, which have the largest number of ACA health plans. State-based marketplaces may also opt to display the quality ratings.

To learn more about the programs, click here. 

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