Issuers offering Qualified Health Plans through Washington Healthplanfinder are required to participate in two federal programs that are intended to evaluate and improve the quality of medical care and services provided to enrollees. Issuers must implement Quality Improvement Strategies, which incentivize providers to offer quality care and encourage enrollees to make healthy choices and develop healthy habits. Issuers also participate in the Quality Rating System, a federal program that collects quality data for the purpose of improving health care quality and performance. Quality data is evaluated and issuers receive ratings based on a 5-star scale. These programs are intended to encourage health plans to focus on quality improvement and to provide more information to consumers about the quality of the health care they receive through their QHP.