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Outpatient Measures

The Medicare Outpatient Prospective Payment System (OPPS) final rule for Calendar Year (CY) 2008 data collection published November 1, 2007, establishes CMS's intent to require hospitals to submit data to CMS on measures for the hospital outpatient setting in CY 2008 in order to get their full payment update in CY 2009.  Ambulatory Surgical Centers (ASCs) will be added for data collection in the future. Hospital outpatient departments and ambulatory surgical centers that fail to report quality measures selected by the Secretary would incur a reduction in their annual payment update by 2.0 percentage points.

Section 109 of the TRHCA of 2006 establishes a statutory requirement consistent with the current proposed OPPS rule to be effective for services beginning in CY 2008. The provision requires the Secretary to develop measures appropriate for the measurement of the quality of care and medication safety furnished by hospital outpatient departments as well as ASCs. Such measures must reflect consensus among affected parties and, to the extent feasible and practicable, must be endorsed by one or more national consensus building entities. Additionally, the Secretary has the authority to replace measures as appropriate and to establish procedures for making data submitted available to the public.

The seven (7) outpatient department measures adopted by CMS for data collection beginning in April of 2008 and payment in CY 2009, focus on the following topic areas:

  1. Emergency Department (ED) Transfers - Acute Myocardial Infarction (AMI) Care
  2. Surgical Care Infection Prevention (SCIP)
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Specifications Manual for Hospital Outpatient Department Quality Measures at QualityNet.org

 

Page Last Modified: 10/02/2008 2:27:13 PM
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