The Hospital Outpatient Quality Reporting (OQR) quality data reporting program was implemented by CMS for outpatient hospital services. Under this program, hospitals report data using standardized measures of care to receive the full annual update to their Outpatient Prospective Payment System (OPPS) payment rate. The OQR program is modeled on the current quality data reporting program for inpatient services, the Hospital Inpatient Quality Reporting Program.
To meet hospital OQR requirements and receive the full Annual Payment Update (APU) under the OPPS, hospitals must meet administrative, data collection and submission and data validation requirements. The current measure set for the Hospital OQR Program includes measures that assess processes of care, imaging efficiency patterns, care transitions, ED throughput efficiency, the use of health information technology, care coordination, patient safety and volume. Participating hospitals agree that they will allow CMS to publicly report data for the quality measures (as stated in the current OPPS Final Rule).
Hospitals that meet data reporting requirements during a given calendar year (CY) receive their full OPPS payment update for the upcoming CY; hospitals that do not participate or fail to meet these requirements may receive a two percent reduction of their payment update.
