The use of Quality Rating and Improvement Systems (QRISs) is continually expanding across the country; in 2010, there were 25 states operating or piloting QRISs and now nearly every other state is planning to or has already begun developing a QRIS or another quality improvement (QI) initiative (Tout, Starr, Soli, Moodie, Kirby, and Boller 2010; U.S. Department of Health and Human Services, 2010b).
The "Good/Better/Best" document was developed from experience in managing the Keystone STARS program, analysis of current research, and insights/suggestions practitioners have shared. The "Good/Better/Best" document can assist practitioners in assessing program strengths as well as help identify next steps for improvement. Thoughtful assessment using a variety of sources of evidence can lead to the development of a meaningful continuous quality improvement (CQI) plan.
The QRIS Cost Estimation Model is a web-based tool that can help users project QRIS costs and allows users to generate multiple reports that compare the cost of a pilot, phased-in approach, or fully implemented QRIS. The model requires users to enter assumptions (e.g., projected participation rates, number of QRIS levels, and provider incentives), and can illustrate how different elements impact cost.
The QRIS Resource Guide is intended as a tool for States and communities to explore key issues and decision points during the planning and implementation of a quality rating and improvement system (QRIS). The Guide is divided into eight sections. Each section contains a set of questions, with guidance for addressing the questions, for States to consider and discuss when planning, implementing, or revising a QRIS.