Outpatient Quality Reporting Program
The 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 CMS. HOPDs that fail to submit the required quality data receive a two-percentage point reduction to their annual payment update. CMS also makes data submitted by HOPDs for the Hospital OQR Program available to the public on Care Compare, permitting patients and their caregivers to review hospitals’ performance on quality measures.
CMS is proposing to adopt the Emergency Care Access & Timeliness electronic clinical quality measure (eCQM) beginning with voluntary reporting for the CY 2027 reporting period followed by mandatory reporting beginning with the CY 2028 reporting period/CY 2030 payment determination.
CMS is also proposing to remove: (1) the COVID–19 Vaccination Coverage Among Healthcare Personnel (HCP) measure beginning with the 2024 reporting period/2026 payment determination; (2) the Hospital Commitment to Health Equity (HCHE) measure beginning with the 2025 reporting period/2027 payment determination; (3) the Screening for Social Drivers of Health (SDOH) measure beginning with the 2025 reporting period; and (4) the Screen Positive Rate for SDOH measure beginning with the 2025 reporting period.
Furthermore, CMS is proposing to remove: (1) the Median Time from Emergency Department (ED) Arrival to ED Departure for Discharged ED Patients (Median Time for Discharged ED Patients) measure and (2) Left Without Being Seen measure, beginning with the 2028 reporting period/2030 payment determination, contingency on the Emergency Care Access & Timeliness eCQM being finalized as proposed.
CMS is also proposing to extend the voluntary reporting for the Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults eCQM, beginning with the 2027 reporting period.
Lastly, CMS is proposing to update the Hospital OQR Program’s Extraordinary Circumstances Exception (ECE) Policy. This proposed update would explicitly include extensions as a type of extraordinary circumstances relief option, in addition to exceptions.
Rural Emergency Hospital Quality Reporting Program
The Rural Emergency Hospital Quality Reporting (REHQR) program is a pay-for-reporting program that requires rural emergency hospitals (REHs) to report data on certain quality measures specified by CMS.
CMS is proposing to adopt the Emergency Care Access & Timeliness eCQM beginning with the 2027 reporting period/2029 program determination as an optional measure (as an alternative the Median Time from ED Arrival to ED Departure for Discharged ED Patients measure). CMS is also establishing related eCQM data submission and reporting requirements beginning with the 2027 reporting period/2029 program determination. CMS is proposing to remove: (1) HCHE measure beginning with the 2025 reporting period/2027 program determination; (2) Screening for SDOH measure beginning with the 2025 reporting period; and (3) Screen Positive Rate for SDOH measure beginning with the 2025 reporting period.
Overall Hospital Quality Star Rating
CMS is proposing to update the methodology used to calculate the Overall Hospital Quality Star Rating to emphasize the contribution of the Safety of Care measure group in hospitals’ ratings. CMS is proposing to make a 2-stage methodologic update, as follows:
- 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. CMS proposes limiting hospitals in the lowest quartile of the Safety of Care measure to a maximum of 4 stars out of 5.
- 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. CMS proposes reducing the Overall Hospital Quality Star Rating of any hospital in the lowest quartile of the Safety of Care measure group by 1 star, to a minimum 1-star rating. Hospitals already receiving one star would not face further star reduction.
Stage 1 methodology update will be used to calculate the Overall Hospital Star Rating in 2026, while the Stage 2 methodology update will be used to permanently calculate the Overall Hospital Star Rating beginning in 2027 and later years. The Stage 2 methodology update is intended to replace the Stage 1 methodology update, not to supplement it. That is, no 5-star hospital will be capped to 4 stars and then further reduced to 3 stars; in both stages, 5-star hospitals could only be reduced to 4 stars.
For more information about Hospital OPPS, you can click on the following link.
The proposed rule (CMS-1834-P) can be downloaded at the Federal Register here: https://www.federalregister.gov/d/2025-13360.