Quality Advisor

The 2026 Quarter 2 Wisconsin Hospitals Quality Snapshot is now available, highlighting how Wisconsin hospitals continue to demonstrate national leadership in health care quality and patient experience.

The latest snapshot emphasizes Wisconsin's continued excellence across multiple quality measures. According to the latest CMS Overall Hospital Quality Star Ratings, Wisconsin ranks fourth in the nation for the percentage of hospitals earning 4- and 5-star ratings and first among states with 50 or more hospitals. In addition, 64% of Wisconsin hospitals earned a 4- or 5-star rating, compared to approximately 42% nationally. These results were also highlighted in a press release July 28, "Wisconsin Hospitals Continue to Rank Among Nation’s Best in Quality."

These achievements, along with the others featured in this snapshot, reflect the strength of Wisconsin's collaborative approach to quality improvement. Hospital leaders are encouraged to review and share the 2026 Quarter 2 Quality Snapshot with boards, leadership teams and community stakeholders.

CMS releases FY 2027 IPPS Final Rule and Statement on the CJR-X Joint Replacement Model

On July 31, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for inpatient and long-term care hospitals under the Medicare hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) for fiscal year (FY) 2027.

The fact sheet discusses major provisions of the final rule, which can be downloaded from the Federal Register.

Here are some overall highlights:

• Beginning October 1, 2026, hospitals will get a 2.3% increase in payments based on a 3.2% increase in the market basket and offset by 0.9% for productivity improvements. CMS estimates total payments will grow by $2.1 billion. The rule also grants long-term care hospitals an identical 2.3% increase in payment rates.
• Hospitals receiving Medicare Graduate Medical Education funding must ensure residency programs do not discriminate or use race, sex, religion, national origin, age, disability or proxies for those characteristics in selecting residents or allocating opportunities.
• CMS also finalized changes to its hospital quality reporting and payment programs. Please see the fact sheet for details on those proposals.

CMS is also expanding an initiative to improve care coordination for hip, knee, and ankle replacements, ensuring providers work together from pre-surgery education through post-op recovery to promote a seamless patient care experience and optimal health outcomes.

Beginning in January 2028, most hospitals will be required to participate in the Comprehensive Care for Joint Replacement Expanded (CJR-X) Model, which is part of the FY 2027 Inpatient and Long-Term Care Hospital Prospective Payment System Final Rule.

The CJR-X Model will be the first expanded mandatory test of an episode-based payment model. Hospitals will be accountable for Medicare expenditures related to joint replacement surgery, hospitalization and the initial 90 days of recovery following hospital discharge, including follow-up treatments like physical therapy.

Forbes 2026 Top Hospitals by State

Wisconsin Has More Five-star Hospitals than Any Other State

Nineteen Wisconsin hospitals earned Forbes' highest overall quality rating in the publication's 2026 Top Hospitals by State rankings - the most of any state in the country.

This national recognition reflects Wisconsin hospitals' continued commitment to delivering exceptional care, improving patient outcomes and providing an outstanding patient experience. Congratulations to our member hospitals on this remarkable achievement!

See the full list of Wisconsin's five-star hospitals here.

2026-2027 Wisconsin Quality Residency Program Begins in September

Register Now for Next Cohort - starts September 9

The Wisconsin Hospital Association (WHA) and the Rural Wisconsin Health Cooperative (RWHC), with support of the Wisconsin Office of Rural Health (WORH), are pleased to announce the next cohort of the Wisconsin Quality Residency Program, beginning September 9.

The program combines in-person and virtual learning sessions and runs from September 9, 2026 through June 16, 2027. See Educational Events & Resources section below for more information or click here to learn more.

The Wisconsin Quality Residency Program is aligned with the nationally recognized competency domains established by the National Association for Healthcare Quality (NAHQ) for the Certified Professional in Healthcare Quality (CPHQ) credential.

CY 2027 OPPS Proposed Rule Analysis

The CY 2027 Outpatient Prospective Payment System (OPPS) proposed rule and the CY 2027 Opps impact analysis are now available.

Estimates for the update to the 340B remedy reduction to the OPPS conversion factor, reduction of payments for 340B-acquired drugs, and the expansion of site-neutral rates for imaging without contrast services furnished in excepted off-campus provider-based department (PBDs) are included in the analysis, with the 340B-acquired drugs payment reduction and site-neutral rates as a breakout of the ambulatory payment classifications (APC)/Factor Updates line.

Bridge to Care Highlights Hospital Innovations in Opioid Use Disorder Treatment

The American Hospital Association's (AHA) Bridge to Care initiative highlights how hospitals and health systems are strengthening care transitions and supporting ongoing treatment engagement for patients with opioid use disorder and stimulant use disorder. The AHA released “Bridge to Care: Continuing the Momentum." Supported by the Centers for Disease Control and Prevention, the webpage features six case studies from hospitals that have improved their care delivery for patients with substance use disorders; the webpage also includes podcasts and a webinar about incorporating best practices in treating use disorders.

Wisconsin Department of Health Services Funding Opportunity: Wisconsin Maternal Health Action Grant

The Wisconsin Maternal Mortality Review (MMR) program works to identify, review and increase awareness of deaths among individuals who die during or within one year of pregnancy. Through an in-depth review process, the Maternal Mortality Review Team (MMRT) identifies contributing factors and develops recommendations aimed at preventing future pregnancy-related deaths. Each recommendation reflects a real person and a real opportunity to improve care. The overall mission of the MMR program is to disseminate the data and recommendations to prevent future maternal deaths and improve the health and safety of birthing people and families across the state.

This funding request will strengthen Wisconsin’s ability to implement MMRT findings to improve the health outcomes of birthing people and mothers in the state. The main goal of this opportunity is to partner with an organization(s) who will be responsible for implementing one or more MMRT recommendation(s). These recommendations should be in collaboration with key stakeholders across the health care and public health system.

Proposed projects should demonstrate a direct and clear connection to one or more of the prioritized recommendations in the application. These recommendations were selected through Wisconsin’s MMRT recommendation prioritization process and reflect opportunities to address two leading contributors to pregnancy-related death in Wisconsin: cardiovascular conditions and mental health-conditions and substance use disorders.

The MMRT’s recommendations have been reorganized into three implementation priority areas for this funding opportunity:

Care coordination, navigation and support

Mental health and substance use response

Quality of care and patient safety

Application details:

• Application due date: August 14, 2026 by 11:59 p.m. CST
• Anticipated project start: October 1, 2026
• Anticipated annual award amount: Up to $50,000

Rural Health Transformation Workforce Grant

The Wisconsin Department of Workforce Development's (DWD) rural health care workforce grant opportunity deadline to apply for year one of the grant is Monday, August 17 at 3 p.m.

Contact WHA Senior Vice President, Workforce and Clinical Practice Ann Zenk with questions about the DWD workforce grants or any other workforce issue.

2027 American Hospital Association Quest for Quality

The American Hospital Association (AHA) is accepting applications for the 2027 Quest for Quality Prize, with submissions open through August 18 at 12 p.m.

Learn more about eligibility, application requirements and submission instructions on the AHA Quest for Quality Prize website.

2027 Hospital Value-Based Purchasing (VBP) Program and Program Percentage Payment Summary Reports (PPSRs) Release Delayed

The Fiscal Year (FY) 2027 Hospital Value-Based Purchasing (VBP) Program Percentage Payment Summary Reports (PPSRs) will be delayed and released in September. The Centers for Medicare & Medicaid Services (CMS) will notify hospitals when the FY 2027 Hospital VBP PPSRs are available on the Hospital Quality Reporting (HQR) Secure Portal via the Hospital IQR Program and Hospital VBP Listservs.

Following the release of the FY 2027 Hospital VBP Program PPSRs, hospitals will have a 30-calendar day review and corrections period.

Caring for Wisconsin's Caregivers    

WHA to Convene Inaugural Caring for Wisconsin’s Caregivers: Workforce Well-being Summit

WHA members are invited to participate in WHA’s inaugural Caring for Wisconsin’s Caregivers: Workforce Well-being Summit on September 10, 2026.

The complimentary summit will launch Phase 2 of the statewide Caring for Wisconsin’s Caregivers initiative and provide Wisconsin health care organizations with early access to The Breen Scale™, an evidence-informed assessment developed by the Dr. Lorna Breen Heroes’ Foundation to help organizations evaluate and strengthen the systems that support workforce well-being.

The summit is designed to meet organizations wherever they are in their workforce well-being efforts and provides an opportunity for members to learn from national experts, connect with peers and consider practical tools that may support ongoing work within their own organizations.

To date, 77 hospitals and health care facilities across more than 30 counties have earned recognition as Wellbeing First Champions, positively impacting more than 22,000 credentialed health care workers statewide.

Summit Details

• Date: September 10, 2026
• Time: 7:30 a.m. – 4:30 p.m.
• Location: Hilton Garden Inn Madison–Sun Prairie
• Register here.

Contact WHA Chief Quality Officer Nadine Allen with questions.

Superior Health Quality Alliance    

CMS 13th Scope of Work Enrollment Extended

The Centers for Medicare & Medicaid Services (CMS) has extended the enrollment deadline for the 13th Scope of Work (SOW). This limited-time extension gives hospitals another opportunity to partner with Superior Health and join the more than 90 Wisconsin hospitals already participating.

The CMS 13th SOW focuses on improving outcomes in chronic disease management, patient safety, behavioral health and care coordination, helping hospitals strengthen quality of care and reduce preventable harm.

We encourage interested hospitals to enroll soon and take advantage of the valuable resources and support available through this initiative.

To enroll, please use this enrollment link to begin the process. Please contact Casey Zimpel with enrollment questions or for more information.

This initiative is aligned with CMS Overall Hospital Star Ratings and Value-Based Purchasing programs, supporting hospitals in improving quality, safety and performance outcomes.

WHA is a member of the Superior Health Quality Alliance (Superior Health), an eight-partner organization focused on improving care for Medicare beneficiaries. They collaborate with patients, clinicians, healthcare organizations and communities across Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin to support the Centers for Medicare & Medicaid Services’ (CMS) quality improvement objectives.