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Hospital Payment and Quality

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CONTACTS
Contact Regulatory and Policy Team

Medicare makes payments to hospitals for inpatient and outpatient hospital services under the Medicare Inpatient Prospective Payment System (IPPS) and Medicare Outpatient Prospective Payment System (OPPS), respectively. The Centers for Medicare & Medicaid Services (CMS) annually publishes IPPS and OPPS proposed regulations that address payment updates and other issues in each payment system, including Medicare’s portfolio of quality reporting and performance programs impacting payment and public reporting.

The CMS releases the IPPS proposed rule between late April and early May and publishes the IPPS final rule in early August; these changes generally become effective on Oct. 1. The CMS issues the OPPS proposed rule between late July and early August and publishes the OPPS final rule in early November; these changes generally become effective on Jan. 1 of the next calendar year (CY).

Learn about the latest IPPS and OPPS proposed regulations using the resources below.

Medicare Inpatient Payment and Quality Reporting

Video

Comment Letters (PDF)

Medicare Outpatient Payment and Quality Reporting

Video

Comment Letters (PDF)

AAMC Regulatory Resources

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