In its CY 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, the Centers for Medicare & Medicaid Services (CMS), introduced a new mandatory patient-reported outcome performance measure (PRO-PM) into the Hospital Outpatient Quality Reporting (OQR) Program.
The Patient Understanding of Key Information Related to Recovery After a Facility-Based Outpatient Procedure or Surgery PRO-PM, shortened as the Information Transfer PRO-PM, becomes mandatory in CY 2027 following one year of voluntary reporting in CY 2026.
According to the Information Transfer PRO-PM methodology report, prepared for CMS by the Yale New Haven Health Services Corporation - Center for Outcomes Research and Evaluation (CORE), “the lack of consistently written documentation in the outpatient setting is associated with worse patient understanding and lower patient involvement in their recovery.”
Considering that “hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) fail to provide patients with critical information about recovery at a much higher rate than inpatient hospitals,” growing demand for outpatient procedures and growing availability of more complex procedures in the outpatient setting necessitates the tracking and measurement of patient understanding surrounding their care experiences.
This one-time 9 question survey, which CMS notes requires an average of 6 minutes for a patient to complete, would be administered 2-7 days after their procedure. According to CMS, “the survey covers three domains for patients or their caregivers to rate the clarity of information received regarding their post-discharge recovery: applicability to patient needs, medication, and daily activities.“ To be eligible, patients must be 18 years or older and have undergone a surgery or procedure at a HOPD with a stay of less than two midnights.
Submission for this PRO-PM is done through the existing Hospital Quality Reporting system, either directly or via a vendor, such as Force Therapeutics. Failure to meet quality reporting requirements for mandatory reporting will result in a 2% reduction to a HOPD’s annual payment update 2 years later (i.e. the first mandatory period in CY 2027 affects payment determination in CY 2029).
Managing the complexities of PRO-PMs is a challenge for hospitals. However, with the right approach—investing in the right technology, understanding new regulations, and optimizing workflows—healthcare providers can improve patient outcomes and avoid financial penalties. Hospital administrators and quality leaders must work together to stay informed, invest wisely, and leverage all available resources to meet the evolving demands of value-based care.
For more information about our platform, visit Force Therapeutics.
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