Affordable Care Act

*Among the ways by which ACHP advocates on behalf of our members is through comment letters. Read comment letters pertaining to Medicare Advantage and the Affordable Care Act.

Quality In The Exchanges

The Affordable Care Act (ACA) directs the Secretary of Health and Human Services to develop a system that rates qualified health plans (QHPs) based on quality and price. The ACA also requires health insurance exchanges to display QHP quality ratings on exchange websites to assist in consumer selection of QHPs.

ACHP strongly supports the long-term value of the Quality Reporting System (QRS) in the exchanges. Given ACHP members’ long-standing commitment to quality care, our role in developing and implementing quality measurement in health plans and our advocacy of value-based purchasing in Medicare and other public and private health care programs, ACHP looks forward to implementation of an effective system for assessing clinical quality and patient experience in the exchanges.

ACHP encourages the use of the Triple Aim framework to guide evolution of the rating system, balancing measures of patient experience, outcomes, and costs. To the extent that outcomes measures are developed and incorporated and costs appropriately captured patients will be better able to assess value as they choose among health plans.

For more information on the quality in the exchanges, please see our comment letters.

Employee Choice In The Small Business Health Options Program

The Small Business Health Options Program (SHOP) exchange helps small businesses provide health coverage to their employees. Through an “employee choice” model, SHOP provides employers the opportunity to allow employees to choose any health plan at the actuarial value (“metal” level) selected by the employer.

ACHP believes that employee choice is at the heart of SHOP’s value proposition. In order for SHOP to be successful in achieving the ACA’s goals, it must offer services that are not readily available to small employers in the outside small group market. This means offering not just competitive prices, but also unique services and better, and more available, information on key consumer issues like quality and plan service. Employee choice is a central component of SHOP’s value that will help it attract enrollment. Along with the premium aggregation function, the employee choice feature will enable small employers to provide their employees a choice of plan while paying a single monthly bill.

For more information on employee choice in the SHOP, please see our comment letters.