Quality Improvement

All issuers offering QHPs through the Exchanges that meet the Quality Improvement Strategy (QIS) participation criteria must comply with the QIS requirements as a condition of certification and participation in the Exchanges. CMS annually publishes the QIS Technical Guidance and User Guide, a detailed guide to the QIS requirements, and the QIS Implementation Plan form, Progress Report form, and Modification Summary Supplement form, which are the QIS reporting tools for issuers applying for QHP certification.

QIS Materials for the 2025 Plan Year

The QIS materials for the 2025 plan year are now available for issuer to download from the Marketplace Quality Initiatives (MQI) website.

  • The QIS Issuer List for the 2025 Plan Year includes issuers operating in Federally-facilitated Exchanges (FFEs) and FFEs where states perform plan management that meet the QIS participation criteria and are required to implement and report on at least one QIS as a condition of QHP certification for the 2025 plan year.
  • The QIS Implementation Plan form, Progress Report form and Modification Summary Supplement form for the 2025 Plan Year (QIS Forms) collect QIS information from issuers in order to demonstrate compliance with section 1311(c)(1)(E) of the Patient Protection and Affordable Care Act. Please note that issuers may use the draft Plan Year 2025 QIS forms that are available on the Marketplace Quality Initiatives (MQI) website to report their QIS information this year.
  • The QIS Technical Guidance and User Guide for the 2025 Plan Year communicates finalized QIS requirements and instructions for how to complete the QIS form.

Issuers should submit questions about QIS to the Marketplace Service Desk (MSD) by phone at 1-855-CMS-1515 (1-855-267-1515) or by email at CMS_FEPS@cms.hhs.gov. When submitting inquiries via email, please include "MQI-QIS" and your HIOS Issuer ID in the subject line or body of the email.