Hospital Inpatient Quality Reporting Program

The Hospital Inpatient Quality Reporting (IQR) Program is a pay-for-reporting program for acute care hospitals. Under this program, CMS requires subsection (d) hospitals to submit data on quality measures to CMS each year. Subsection (d) hospitals are acute care hospitals that are paid under the Inpatient Prospective Payment System. Subsection (d) hospitals exclude the following types of hospitals: children’s, inpatient psychiatric, long-term care, rehabilitation hospitals and the 11 Prospective-Payment System Exempt cancer hospitals.

Data collected under the Hospital IQR Program is publicly available to consumers and providers on the Care Compare website at: https://www.medicare.gov/care-compare/?providerType=Hospital. This data transparency helps consumers make more informed decisions about healthcare options and encourages hospitals and clinicians to improve the quality of inpatient care provided to all patients.

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.

Data from selected measures are also used under the value-based purchasing programs to reward providers for the quality of care they provide. Payments for these hospitals that are participating in the Hospital Value-Based Purchasing, Hospital-Acquired Condition Reduction Program, and Hospital Readmissions Reduction Program are adjusted based on the quality of care they deliver.

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