Comprehensive Hospital Increase Reimbursement Program (CHIRP)

The Comprehensive Hospital Increase Reimbursement Program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved CHIRP for state fiscal year (SFY) 2022 (Year [Y] 1) on March 25, 2022. CMS approved CHIRP for SFY 2023 (Y2) on August 1, 2022.


CHIRP is a DPP for hospitals providing healthcare services to adults and children enrolled in the STAR and STAR+PLUS Medicaid managed care programs. Eligible hospitals include children's hospitals, rural hospitals, mental health hospitals, state-owned hospitals, and urban hospitals.

The program is a change to the previous Uniform Hospital Rate Increase Program (UHRIP).

  • Component 1: UHRIP provides a uniform rate enhancement on all hospital inpatient and outpatient services claims.
  • Component 2: Average Commercial Incentive Award (ACIA) is a uniform rate enhancement above the UHRIP rate, based upon a percentage of the estimated average commercial reimbursement. Participating hospitals may opt into this component.

Proposed SFY 2024 (Y3) Measures and Requirements

HHSC will conduct an online public hearing on January 10, 2023, at 10:00 a.m. CST to receive public comment on proposed quality measures and reporting requirements for SFY 2024 (Y3) of CHIRP. Additional information on the hearing is available on the HHS Meetings & Events Page.

This hearing will be conducted online only and will not have a physical location. Please register for this hearing at this link.

Briefing Packet

Written Public Comments

Written comments regarding the proposed quality measures and reporting requirements may be submitted until 11:59 p.m. on January 27, 2023 at this link.

SFY 2023 (Y2) Measures, Requirements, and Evaluation

SFY 2022 (Y1) Measures, Requirements, and Evaluation


CHIRP rules §353.1306 and §353.1307

Contact Information


DPP Contact Change Form (PDF)