What is a Qualified Health Plan (QHP)?

Qualified Health PlanUnder the Patient Protection and Affordable Care Act (ACA), each state is required to establish a fully operational state healthcare exchange by January 1st 2014. These exchanges will essentially function as insurance marketplaces from which individual consumers and small businesses will be able to purchase insurance from a number of different providers.

The responsibility of selecting which private market insurance plans to offer in a state’s exchange falls onto the decision makers establishing public policy for the exchange. Plans that are chosen are known as “Qualified Health Plans” (QHP), while the selection process itself is often referred to as “QHP certification.”

Given the monumental task at hand, some states are turning to healthcare consultants to aide in their QHP certification efforts. In December of this last year, bluecrane was engaged by California’s healthcare exchange (Covered California) to structure, organize, and help manage the state’s QHP certification process. At Covered California, bluecrane has applied our core competencies in project management and procurement, and our experience in the health care sector to optimize processes to accommodate the unyielding ACA timelines. Our consultants have organized evaluation teams into areas of specialty, trained them on QHP evaluation, and developed “tips and tricks” to assist evaluators in meeting aggressive selection timelines. bluecrane recognizes that each state is unique and different, and we’ve developed QHP selection processes that are very flexible and easily transferable to any state.

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