New CMS Measures Emphasize Patient Outcomes in Hip and Knee Replacement

Introduction

This newsletter provides an update on the Centers for Medicare & Medicaid Services (CMS) focus on Patient-Reported Outcomes (PROs) following Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) procedures.

What is the CMS THA/TKA PRO Program?

The CMS THA/TKA PRO program is a new initiative that requires hospitals to collect patient-reported data on pain and function following these joint replacement surgeries. This data will be used to assess hospital performance and improve patient care.

Why are PROs Important?

Traditionally, hospital performance has been measured by objective factors like readmission rates and length of stay. However, PROs add a valuable patient perspective by measuring how much their pain and function have improved after surgery. This information is crucial for understanding the overall success of a joint replacement procedure.

What are the Requirements?

The program is being implemented in a phased approach:

Mandatory collection for Inpatient THA/TKA: Began April 2, 2024, with reporting due September 30, 2025 (voluntary reporting periods in 2023 and 2024).
Mandatory collection for Outpatient THA/TKA: Now in effect. Hospitals must collect PRO data using specific instruments like the HOOS JR (THA) and KOOS JR (TKA) pre-operatively and again at least one year post-operatively. They are required to submit data for at least 50% of eligible patients.

Some data points that will prove the point

Multicenter Analysis of Patient-Reported Outcomes Following Elective Total Joint Replacement [Link to study] This study, published in the Journal of Arthroplasty, analyzed data from over 11,000 patients undergoing total joint replacement and found that PRO scores significantly improved after surgery, with substantial improvements reported by a high percentage of patients.

What are the Benefits?

The CMS THA/TKA PRO program has several potential benefits:

Improved Patient Care: By focusing on patient-reported outcomes, hospitals can identify areas for improvement in their care processes and better meet patient needs.
Enhanced Patient Engagement: The program encourages communication between patients and providers about their recovery goals.
Public Reporting: Hospital performance data will be publicly available, allowing patients to make informed decisions about their care.

How Bestoutcomes Can Help

Bestoutcomes, a user-friendly tool, can streamline your hospital's compliance with the CMS THA/TKA PRO program. Here's how:

Streamlined Data Collection: Bestoutcomes simplifies the collection of pre- and post-operative PRO data using validated instruments like HOOS JR and KOOS JR.
Enhanced Patient Engagement: The tool offers patient-friendly interfaces for easy completion of PRO surveys.
Automated Reporting: Bestoutcomes automates data aggregation and reporting, saving valuable staff time and resources.
Improved Quality Assurance: The tool offers features to monitor data completeness and identify missing information.
Benchmarking Capabilities: (Optional) Bestoutcomes can provide benchmarking reports to compare your hospital's performance against regional or national averages.

By partnering with Bestoutcomes, your hospital can not only achieve compliance with the CMS THA/TKA PRO program but also leverage valuable data to continuously improve patient care and achieve exceptional outcomes in joint replacement surgeries.