Hospital Outpatient Quality Reporting Program
The Hospital Outpatient Quality Reporting (OQR) Program is a pay-for-reporting program that requires hospital outpatient departments (HOPDs) to report data on certain quality measures specified by the Centers for Medicare & Medicaid Services (CMS). The HOPDs that fail to submit the required quality data receive a 2-percentage point reduction to their annual payment update under the OPPS. The data submitted by HOPDs for the Hospital OQR Program will be made available to the public on Care Compare, permitting patients and their caregivers to review hospitals’ performance on quality measures.
The rule finalizes the adoption of the Emergency Care Access & Timeliness electronic clinical quality measure (eCQM) beginning with voluntary reporting for the 2027 reporting period, followed by mandatory reporting beginning with the 2028 reporting period.
The rule removes the following measures:
- COVID–19 Vaccination Coverage Among Healthcare Personnel (HCP) measure beginning with the 2024 reporting period
- Hospital Commitment to Health Equity (HCHE) measure beginning with the 2025 reporting period
- Screening for Social Drivers of Health (SDOH) measure beginning with the 2025 reporting period
- Screen Positive Rate for SDOH measure beginning with the 2025 reporting period
Furthermore, CMS is finalizing the removal of (a) the Median Time from Emergency Department (ED) Arrival to ED Departure for Discharged ED Patients (Median Time for Discharged ED Patients) measure, and (b) Left Without Being Seen measure, beginning with the CY 2028 reporting period/CY 2030 payment determination. These measures will be replaced by the Emergency Care Access & Timeliness eCQM.
The rule extends voluntary reporting for the Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults (Excessive Radiation) eCQM, beginning with the 2027 reporting period.
Lastly, CMS is finalizing an update to the Hospital OQR Program’s Extraordinary Circumstances Exception (ECE) Policy. This finalized update will explicitly include extensions—in addition to exceptions—as a type of extraordinary circumstances relief option and change the length of time to submit an ECE request from 90 days to 60 days after a qualifying event.
Rural Emergency Hospital Quality Reporting Program
The Rural Emergency Hospital Quality Reporting (REHQR) Program is a quality reporting program that requires REHs to report data on certain quality measures specified by CMS.
The rule adopts the Emergency Care Access & Timeliness eCQM beginning with the 2027 reporting period as an optional measure—specifically as an alternative to reporting the Median Time from ED Arrival to ED Departure for Discharged ED Patients measure. The rule also establishes related eCQM data submission and reporting requirements beginning with the 2027 reporting period.
The rule removes the following measures:
- HCHE measure beginning with the 2025 reporting period
- Screening for SDOH measure beginning with the 2025 reporting period
- Screen Positive Rate for SDOH measure beginning with the 2025 reporting period
Lastly, CMS is finalizing updates to the Hospital REHQR Program’s ECE Policy. This final update will (a) explicitly include extensions—in addition to exceptions—as a type of extraordinary circumstances relief option, and (b) change the length of time to submit an ECE request from 90 days to 60 days after a qualifying event.
Hospital Quality Star Rating
Measures that are publicly reported on the provider comparison tool on Medicare.gov (https://www.medicare.gov/care-compare/) are organized into five conceptually coherent measure groups under the Overall Star Rating: Safety of Care, Mortality, Readmission, Patient Experience, and Timely and Effective Care.
CMS is finalizing policies to make a two-stage methodologic update in the 2026 OPPS final rule:
- Stage 1: Implement a 4-star cap for hospitals in the lowest quartile of the Safety of Care measure group performance in Calendar Year 2026.
- Stage 2: Implement a blanket 1-Star reduction for hospitals in the lowest quartile of Safety of Care measure group performance beginning in Calendar Year 2027.
For more information about the 2026 OPPS final rule, you can click on the following link: Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Final Rule (CMS-1834-FC) | CMS.