How State Exchanges Can Implement Health Plan Quality Reporting

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Meeting Details

Dec 31 1969

Download the slides and video recording here.

AcademyHealth and NCQA hosted a webinar, “How State Exchanges Can Implement Health Plan Quality Reporting.” The Affordable Care Act (ACA) contains several quality reporting requirements for plans participating in health insurance exchanges. This webinar examined what those requirements are, and highlighted examples of how state purchasers have already integrated health plan quality reporting and improvement strategies in their existing programs.  Finally, the webinar reviewed some concrete ways to implement the ACA requirements in phases and by strategically building for the future. States are already collecting considerable amounts of data for a variety of reasons, and this webinar demonstrated how those efforts can be leveraged to meet the ACA requirements for plans participating in exchanges.


Wendy Long, MD, MPH, Chief Medical Officer, Bureau of TennCare, presented on Tennessee’s Medicaid program, highlighting how the state has built its data infrastructure from existing activities.

Richard KP Sun, MD, MPH, Medical Consultant to the Health Plan Administration Division, Health Policy and Planning, California Public Employees' Retirement System (CalPERS), focused on how California’s State Employee Benefit program has connected its quality reporting to broader delivery system reform efforts underway in the state.

Finally, Ledia Tabor, MPH from NCQA, offered concrete ways that states can implement new requirements around quality reporting, quality improvement, and accreditation. These steps will be grouped into two phases, and will address such topics as: undertaking a gap analysis to determine what is ongoing in your state, developing metrics for plan quality improvement information, developing cost of care metrics, thinking about how to align metrics with Medicaid and State Employee Benefits purchasing, developing decision support tools for plan/provider selection, developing incentive programs, and testing the effectiveness of web information, and the use of Navigators or producers, among others.