Hospital Outpatient Quality Reporting Program
The Centers for Medicare & Medicaid Services (CMS) uses a variety of data sources to determine the quality of care that Medicare beneficiaries receive.
For the measure sets listed below, CMS uses Medicare Outpatient claims data submitted by hospitals for Medicare fee-for-service patients. Each measure set is calculated using a separate, distinct methodology and, in some cases, separate discharge periods.
- Hospital Outpatient Quality Reporting (OQR) Quality Measures - Includes process of care, imaging efficiency patterns, care transitions, ED-throughput efficiency, use of health information technology (HIT), care coordination, patient safety, and volume measures.
- Colonoscopy Measure – This outcome measure for the Outpatient setting is meant to provide facilities with information on patient outcomes that will allow them to improve quality of care for patients undergoing low-risk colonoscopy.
- Imaging Efficiency Measures – Includes six publicly reported measures calculated using data from hospital Outpatient claims: MRI lumbar spine for low back pain, mammography follow-up rates, abdomen computed tomography – use of contrast material, thorax CT – use of contrast material, cardiac imaging for preoperative risk assessment for non-cardiac low-risk surgery, and simultaneous use of brain CT and sinus CT.
- Chemotherapy Measure – This claims-based outcome measure provides facilities with information on patients undergoing chemotherapy treatment in the outpatient setting and is intended to facilitate quality improvement efforts. A dry run of this measure will begin in August 2017.
- Surgery Measure – This claims-based outcome measure provides facilities with information on hospital visits within seven days of hospital outpatient surgery that will allow them to improve the quality of care at their facility. A dry run of this measure will be held in September 2017.