A systemic effort or process to ensure requirements and quality standards are met.

QI is the degree to which health services for individuals increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Quality improvement is the framework used to systematically improve care.

This is a CMS quality rating system used to calculate a quality rating for each health plan sponsor based on a five-star scale for the Health Insurance Exchanges. In Medicare Part D, the quality rating system is called Medicare Star Ratings.

A QL is the maximum amount of a drug that can be dispensed per prescription under a plan’s benefit design. QLs are used as a measure to ensure appropriate use.