Hospital Inpatient Quality Reporting Program

Hospital Inpatient Quality Reporting Program

The Hospital Inpatient Quality Reporting Program was originally mandated by Section 501(b) of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. This section of the MMA authorized CMS to pay hospitals that successfully report designated quality measures a higher annual update to their payment rates. Initially, the MMA provided for a 0.4 percentage point reduction in the annual market basket (the measure of inflation in costs of goods and services used by hospitals in treating Medicare patients) update for hospitals that did not successfully report. The Deficit Reduction Act of 2005 increased that reduction to 2.0 percentage points. This was modified by the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act of 2010, which provided that beginning in fiscal year (FY) 2015, the reduction would be by one-quarter of such applicable annual payment rate update if all Hospital Inpatient Quality Reporting Program requirements are not met.

Under the Hospital Inpatient Quality Reporting Program, CMS collects quality data from hospitals paid under the Inpatient Prospective Payment System, with the goal of driving quality improvement through measurement and transparency by publicly displaying data to help consumers make more informed decisions about their health care. It is also intended to encourage hospitals and clinicians to improve the quality and cost of inpatient care provided to all patients. The data collected through the program are available to consumers and providers on the Hospital Compare website at: https://www.medicare.gov/hospitalcompare/search.html. Data for selected measures are also used for paying a portion of hospitals based on the quality and efficiency of care, including the Hospital Value-Based Purchasing Program, Hospital-Acquired Condition Reduction Program, and Hospital Readmissions Reduction Program.

Additional information on the Hospital Inpatient Quality Reporting Program can be found at the links listed below.