CMS is adding OAS CAHPS to the Overall Hospital Quality Star Ratings. What to know.

By Eme Augustini, Policy Director, Thought Leadership, Press Ganey

Patient experience has long been a defining signal of a hospital’s quality. With a recent CMS update, it will play a slightly broader role in how organizations are evaluated in public reporting. During a recent CMS‑hosted webinar, the agency announced that Outpatient and Ambulatory Surgery CAHPS (OAS CAHPS) measures will be incorporated into the Patient Experience domain used to calculate the Overall Hospital Quality Star Ratings, beginning with the 2026 annual Star Rating update.  

This is the first formal communication from CMS about the change, and while it has naturally prompted early questions, there is time to review details during the preview period—and Press Ganey will continue to provide clear guidance on any implications to our clients’ patient experience measurement strategy.  

What CMS announced 

Starting with the 2026 cycle, CMS will fold OAS CAHPS into the Patient Experience measure group within the Overall Hospital Quality Star Ratings methodology. CMS indicated the addition during a public webinar and in the accompanying slide deck. While the agency has longstanding methodology resources for the Overall Star Ratings, those materials have not yet been updated to reflect the inclusion of OAS CAHPS or the related restructuring shown in the webinar.  

CMS’s webinar materials suggest two notable developments. First, OAS CAHPS results will be integrated into the Patient Experience group used for Overall Stars. This is a meaningful expansion: It brings outpatient surgical settings explicitly into view when CMS calculates a hospital’s overall star. Second, CMS appears to be presenting certain HCAHPS items as single‑item measures rather than as components within broader composites. In the slides, Cleanliness, Quietness, Overall Rating, and Willingness to Recommend are displayed as stand‑alone measures. 

What this change does—and does not—do

It’s important to situate this update in the broader Star ecosystem. The change does not: 

• Create a new quarterly, OAS‑specific Star Rating; that effort remains in development. 

• Modify or replace the existing quarterly HCAHPS Star Ratings. 

• Affect Medicare payment.  

And, it applies only to Hospital Outpatient Departments (HOPDs). Ambulatory Surgery Centers (ASCs) remain outside the scope of the Overall Hospital Quality Star Rating program. 

What does change is the composition of the Patient Experience domain for Overall Stars. Beginning in 2026, that domain will include measures from both HCAHPS (inpatient) and OAS CAHPS (outpatient surgery). Because Overall Star Ratings are public facing on Care Compare and frequently cited in media and third‑party rankings, the inclusion of OAS CAHPS will extend the public narrative of patient experience beyond inpatient care alone. 

How the Overall Hospital Quality Star Ratings work (quick refresher)

CMS summarizes hospital performance across five measure groups—Mortality, Safety of Care, Readmissions, Patient Experience, and Timely & Effective Care—to assign 1 to 5 stars. Each hospital’s summary score is built through a multi‑step process that includes selecting and standardizing measures, calculating group scores, weighting those groups, placing hospitals into peer groups, and then using a clustering algorithm to assign the final star. Patient Experience carries a 22% weight in the summary score—on par with Mortality, Safety, and Readmissions—so changes to what’s inside that domain can shift overall results. 

Methodology status and follow‑up 

CMS’s posted background and methodology documents for the Overall Star Ratings program currently do not reflect OAS CAHPS inclusion or the Patient Experience restructuring shown in the webinar.  

CMS also finalized a separate policy, elevating Safety of Care within the Star Ratings framework—moving safety from a contributing factor to a potential constraint on overall results. While distinct from the OAS CAHPS change, it underscores CMS’s broader direction: greater emphasis on fundamental care experience and outcomes, with clearer consequences inside the Star Ratings. 

What hospitals can expect next

According to CMS’s timeline, Hospital‑Specific Reports will be available beginning February 19, with a preview period running through March 20, ahead of the May 13 public release of the 2026 Overall Hospital Quality Star Ratings. These preview reports are the primary mechanism hospitals use to review and validate their results before they appear publicly on Care Compare. 

Given the addition of OAS CAHPS and the potential restructuring of HCAHPS items, leaders should plan to review their Patient Experience detail closely during this window. 

What this signals for PX strategy

The inclusion of OAS CAHPS in Overall Stars signals that patient experience in outpatient surgical settings will now help define a hospital’s public quality profile. For leaders, this elevates three priorities: 

• Strengthen measurement coverage and data quality for OAS CAHPS. 

• Reinforce experience fundamentals that span inpatient and outpatient care—especially communication, discharge preparation, and global signal items. 

• Prepare communications teams to contextualize any shifts in star performance related to the updated Patient Experience domain. 

A final word

CMS’s decision to bring OAS CAHPS into the Overall Hospital Quality Star Ratings broadens the role of patient experience in public reporting. While some methodological details are still forthcoming, hospitals will have a clear opportunity to review their information during the preview period, and we’ll continue to translate CMS updates as they arrive. Outpatient surgical experience will become another aspect of the story hospitals tell—through their stars—about the quality of care they deliver. 

Looking for more insight into these regulatory updates? Join us on March 11 as Chrissy Daniels, Deirdre Mylod, and Eme Augustini share more in a webinar.