The Affordable Care Act calls for the U.S. Secretary of Health and Human Services to issue quality improvement reporting requirements for employer group health plans, including self-insured plans, and individual plans, as well as for qualifying plans in health insurance exchanges. Health plans will need to report on their quality improvement activities regarding plan or coverage benefits and provider reimbursement structures that: improve health outcomes, prevent hospital readmissions, improve patient safety and reduce medical errors, and implement wellness and health promotion activities. Mindful of the opportunity to leverage existing plan reporting tools and achieve administrative efficiencies, this report summarizes key features of the eValue8 Health Plan Request for Information, National Committee for Quality Assurance accreditation, and Medicaid's external quality review process. The authors offer the National Quality Strategy as a framework for quality improvement reporting requirements to align efforts among health plans, health care providers, and health care purchasers.
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