Exploring the evolution of insurance exchanges: quality assurance services

Deltek Analyst Aila Altman reports.

Continuing this week’s blog series recognizing Deltek’s recently-released report, “Evolving Health Insurance Exchanges,” we’re drawing attention to an element of health insurance exchanges (HIXs) that has thus far received little attention: quality assurance (QA) services. The lack of focus on these services can be easily pinned to the early nature of HIXs and delayed implementation efforts of many states. However, as more states implement state, federal or hybrid exchanges, they will need to start considering and implementing quality measures.

States further along in HIX planning efforts such as Colorado, New York and Mississippi may have a clearer vision of needed QA practices than those that continue to delay planning and implementation. Similarly, states that have made progress in modernizing eligibility determination systems into integrated eligibility determination engines may already be planning for or have existing QA contracts in place.

As vendors continue to see more exchange-related opportunities arise as the 2014 deadline approaches, they will likely see an influx of quality-related opportunities. Though still in its draft stages, once released, federal guidance on the exchanges will hopefully contain concrete QA-related direction for states. Meanwhile, many states are anxiously awaiting the March 2012 Supreme Court verdict on the Patient Protection and Affordable Care Act (PPACA) before taking any additional steps toward HIX implementation.

For the complete blog, go here.