Hospital Inpatient Overview

The Centers for Medicare & Medicaid Services (CMS) oversees several initiatives designed to improve hospital care, enhance patient safety, and promote the use of innovative technologies. These programs focus on driving better outcomes by linking quality performance to financial incentives, reducing preventable complications, minimizing unnecessary readmissions, and fostering transparency through public reporting. Together, they aim to elevate healthcare standards and empower patients with valuable insights into hospital performance.

CMS uses a variety of measures to determine the quality of care provided during inpatient hospital stays:

For Claims-Based measures, CMS uses Medicare enrollment data and Part A and Part B claims data.
For Chart-Abstracted Clinical Process of Care measure data submission, the hospital or the hospital's vendor abstracts data for these measures from medical records and submits the data to CMS.
Electronic Health Record (EHR)-Based Clinical Process of Care measures are electronic clinical quality measures (eCQMs) that are expressed and formatted to use data from EHRs and/or health information technology systems to measure healthcare quality, specifically, data captured in structured formats during the process of patient care. Please Note: Any data submitted as an eCQM will not be posted on the Hospital Compare website. Public reporting of eCQM data will be addressed in future rulemaking.
Healthcare-Associated Infection (HAI) measure data are submitted by hospitals to the Centers for Disease Control and Prevention (CDC) via the National Healthcare Safety Network (NHSN) application. The CDC sends HAI data to CMS prior to each submission deadline.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey is a standardized survey to gather patient perspectives on hospital care. Hospitals or their vendors report data obtained from the survey to CMS.