Hospital Outpatient Quality Reporting Overview
Background and Purpose
Hospital Outpatient Quality Reporting Program initial implementation is outlined in the Outpatient Prospective Payment System (OPPS) Final Rule (PDF) released November 1, 2007. Under this program, hospitals report data for services on the quality of hospital outpatient care using standardized measures of care to receive the full annual update to their OPPS payment rate, effective for payments beginning in calendar year (CY) 2009. The Hospital OQR Program is modeled on the current quality data reporting program for inpatient services, the Hospital Inpatient Quality Reporting Program, formerly known as the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) Program.
Provider Support
FMQAI was selected by the Centers for Medicare & Medicaid Services (CMS) as the Hospital OQR Program Support Contractor (SC). FMQAI supports activities to assist hospitals with quality data reporting under the Hospital OQR Program, which includes providing technical support and feedback.
Summary of Hospital OQR Program Requirements
To meet the Hospital OQR Program requirements and receive the full Annual Payment Update (APU) under the OPPS, hospitals must meet administrative, data collection and submission, and data validation requirements; included is the submission of data for 23 quality measures: 14 clinical performance measures; seven Imaging Efficiency Measures; and two web-based Structural Measures. Participating hospitals agree that they will allow CMS to publicly report the quality measures (as stated in the OPPS final rule.)
For more information on the measures, please visit Measure Sets and the Specifications Manual for Hospital Outpatient Department Quality Measures. Detailed requirements for hospitals participating in the HOP QRP initiative may be found at QualityNet Reference Checklist.