2027 IPPS Final Rule
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CMS published the final rule for Hospital Inpatient Quality Reporting and Medicare Promoting Interoperability programs for FY 2027.
TL/DR
The CY 2024 OPPS Proposed Rule includes significant updates to the Hospital Outpatient Quality Reporting Program.
- Three new measures proposed: Patient-Reported Outcomes for THA/TKA, Outpatient Surgical Volume (re-adoption), and Excessive Radiation Dose CT eCQM
- COVID-19 HCP measure updated to align with CDC "Up to Date" specifications
- Colonoscopy follow-up measure denominator expanded from ages 50-75 to ages 45-75
- Left Without Being Seen measure proposed for removal; non-compliance carries a 2.0 percentage point payment reduction
CMS proposed three new OQR measures including a patient-reported outcomes measure, modified three existing measures, and proposed removing LWBS.
CMS unveiled proposals for the Hospital Outpatient Quality Reporting Program, encompassing three new measures, refinements to existing ones, and one removal. The complete rule text appears in the Federal Register.
Proposed New Measures
- Risk-Standardized Patient-Reported Outcomes Following Elective Primary Total Hip and/or Total Knee Arthroplasty: CY 2025-2026 voluntary, CY 2027 mandatory
- Hospital Outpatient/ASC Facility Volume Data on Selected Outpatient Surgical Procedures (re-adoption with modifications): CY 2025 voluntary, CY 2026 mandatory
- Excessive Radiation Dose or Inadequate Image Quality for Diagnostic CT in Adults (eCQM): CY 2025 voluntary, CY 2026 mandatory
Proposed Measure Modifications
- COVID-19 Vaccination Coverage Among HCP: Aligns with updated CDC specifications, introduces "Up to Date" terminology
- Cataracts: Improvement in Patient's Visual Function: Standardizes survey instruments beginning voluntary CY 2024
- Appropriate Follow-Up Interval for Normal Colonoscopy: Denominator modified from ages 50-75 to ages 45-75
Proposed Measures to Remove
The Left Without Being Seen Measure: Removal effective CY 2024 reporting period because it fails to provide actionable information in sufficient detail to improve quality or patient outcomes.
Data Submission Timing
Payment Reduction for Non-Compliance
Hospitals failing to submit required measure data face a 2.0 percentage point reduction to annual payment updates.
For OQR reporting questions, contact Acmeware.
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