CMS released the CY 2023 OPPS Final Rule, which included updates to the Hospital Outpatient Quality Reporting Program (OQR). For complete details, refer to the Federal Register.

Measures

The OP-31 measure status changed significantly. Previously finalized as mandatory beginning CY 2025, CMS now maintains it as voluntary.

Following OP-26's removal, the program lacks outpatient surgical procedure volume tracking. CMS solicited feedback on reimplementing OP-26 or another volume measure given the increased importance of monitoring outpatient procedures as services shift from inpatient settings.

Data Submission Timing

Beginning CY 2024 reporting (CY 2026 payment determination), patient encounter quarters for chart-abstracted measures align with calendar years. All four quarters reflect data from two years prior to the payment year, matching Hospital IQR program timelines.

For transition purposes, the CY 2023 reporting period uses three quarters of data for chart-abstracted measures.

Validation

CMS randomly selects 450 hospitals plus 50 additional facilities based on targeting criteria. Beginning with CY 2023 reporting, a new fifth criterion targets hospitals with fewer than four quarters of validation data due to Extraordinary Circumstances Exceptions and confidence intervals below 75%.

For OQR reporting questions, contact Acmeware.