Overview

Hospital Outpatient Quality Reporting (OQR) Program

Background and Purpose

The Hospital Outpatient Quality Reporting (OQR) Program is a quality data reporting program implemented by the Centers for Medicare & Medicaid Services (CMS) for outpatient hospital services. Under this program, hospitals report data using standardized measures of care to receive the full update to their Outpatient Prospective Payment System (OPPS) payment rate. Modeled after the Hospital Inpatient Quality Reporting Program, the Hospital OQR Program became effective for payments beginning in calendar year (CY) 2009.

Provider Support

HSAG was selected by CMS as the Hospital OQR Program Support Contractor. HSAG provides technical support, feedback, and other services to assist hospitals with quality data reporting under the Hospital OQR Program.

Summary of Hospital OQR Requirements

The Hospital OQR Program is a quality data reporting program for outpatient hospital services implemented by CMS. CMS focuses on reporting measure data that have high impact and support national priorities for improved quality and efficiency of care for Medicare beneficiaries.

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 is stated in the current OPPS/ASC final rule.

Hospitals that meet data reporting requirements during a given calendar year (CY) receive their full Outpatient Prospective Payment System (OPPS) payment update for the upcoming calendar year; those hospitals that do not participate or fail to meet these requirements may receive a two percent reduction of their payment update.

Detailed requirements for hospitals participating in the Hospital OQR Program may be found in the Hospital OQR Program Reference Checklist.

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