Comprehensive Hospital Increase Reimbursement Program (CHIRP)

The Comprehensive Hospital Increased 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 on March 25, 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 State Fiscal Year (SFY) 2023 (Year [Y]2) Measures, Requirements, and Evaluation

HHSC conducted a public hearing on January 13, 2022 to review proposed measures and reporting requirements for Y2 of CHIRP.

SFY 2022 (Y1) Measures, Requirements, and Evaluation


CHIRP rules §353.1306 and §353.1307

Contact Information


DPP Contact Change Form (PDF)