What Are State Health Insurance Exchanges?

Health insurance Exchanges are state-based marketplaces for individuals to purchase health insurance. The Affordable Care Act (ACA) requires health insurance Exchanges to meet specific quality requirements. Exchanges must verify that insurers are accredited, collect quality data and assess health plan quality improvement.


These requirements allow states to build Exchanges that help people find plans that offer the best quality and value, not just cheap premiums. To learn more, please see the NCQA White Paper, “Building State Exchanges to Get Better Value.”  Check out the Webinar slides. Listen to the January 16, 2013 Webinar.

Accreditation for Health Plans Participating in Exchanges 
  • The Department of Health and Human Services (HHS) nominated NCQA as an accrediting entity for Qualified Health Plan issuers participating in Health Insurance Exchanges. 
  • NCQA’s Health Plan Accreditation (HPA) contains all the key elements the law requires. 
  • HPA 2013 streamlines the accreditation process by reducing administrative burdens for new and currently accredited health plans.
  • HPA 2013 creates three accreditation evaluation options and comprise a “glide path”—flexible opportunities for reaching accreditation, regardless of a plan’s longevity or experience with quality reporting. 

To see specific details on the strong alignment between NCQA Health Plan Accreditation and State Health Insurance Exchange Accreditation requirements, please click here