Key Takeaways
- New Reporting Requirements for THA/TKA Procedures Begin Soon The pre-procedure data collection window for voluntary reporting of the inpatient THA/TKA PRO-PM kicks off in October 2024. Mandatory reporting starts in 2025.
- Financial Penalties for Non-Compliance Non-compliance with THA/TKA PRO-PM reporting can risk in a 2% cut across your entire organization's annual Medicare reimbursements, not just THA/TKA procedures.
- Free Consultation to Assess Your Risk Let us analyze your situation and estimate potential financial penalties for non-compliance.
- Streamline THA/TKA PRO-PM Reporting with Best Outcomes Our ePRO tool automates data collection, simplifies data export, and provides actionable insights to ensure you meet CMS requirements and avoid penalties.
Reporting requirements at a glance
To avoid financial penalties, providers must report the following to CMS
- Data Collection: 30 days prior to surgery & one year post OP
- SCB: -HOOS, JR: 22 points-KOOS, JR: 20 points
THA/TKA PRO - PM measure
- CMS pays acute care hospitals for inpatient stays under a payment program called the inpatient Prospective Payment System (IPPS).
- Hospital inpatient Quality Reporting (IQR) collects data from Hospitals.
- PRO data; claims data; Medicare enrollment and beneficiary data.
- CMS for measure calculation directly or utilize an external entity, such as a vendor or registry,
- Hospitals that fail to meet any of the IPPS reporting requirements will receive a deduction from their annual payment update FY 2028.
The Challenge: New CMS Reporting Mandates for THA/TKA
Similar to the inpatient program in 2022, the Centers for Medicare & Medicaid Services (CMS) is now mandating reporting of the THA/TKA PRO-PM for inpatient procedures in both Hospital inpatient and ASC Quality Reporting Programs.
The Deadline is Approaching
The 2025 reporting pre-procedure collection window begins on October 3rd, 2024. Don't wait until the last minute!
Best Outcomes: Your Partner in THA/TKA PRO-PM Compliance
Avoid financial penalties and ensure smooth reporting with Best Outcomes! Our user-friendly ePRO tool offers:
- Automated Data Collection Reduce administrative burden and ensure complete datasets.
- Actionable Insights Turn patient-reported data into meaningful information to guide care and improve patient outcomes.
- Simplified Data Export Easily export data in the format required by CMS.
- Improved Patient Engagement Enhance patient communication and satisfaction through ePRO surveys.
Get Started Today!
Don't risk financial penalties. Contact Best Outcomes today for a free consultation and learn how our ePRO tool can help you achieve seamless THA/TKA PRO-PM compliance.
| Data Element Type | Preoperative Data Elements | Postoperative Data Elements |
|---|---|---|
| Patient-Reported Outcome Measures (PROMs) | THA patients:HOOS, JR TKA patients:HOOS, JR | THA patients:HOOS, JR TKA patients:HOOS, JR |
| Patient-Or-Provider-Reported Risk Variables | Mental Health Subscale items from either PROMIS-Global or VR-12 | N/A |
| Health Literacy (SILS2) | ||
| BMI or Height/Weight | ||
| Use of Chronic Narcotics | ||
| Total Painful Joint Count: Patient-Reported Pain in Non-Operative Lower Extremity Joint | ||
| Quantified Spinal Pain: Patient-Reported Back Pain, Oswestry Index Question | ||
| Matching Variables | Medicare Provider Number | Medicare Provider Number |
| MBI | MBI | |
| Date of Birth | Date of Birth | |
| Date of Procedure | Date of Procedure | |
| Procedure Type | Procedure Type | |
| Date of Admission | Date of Admission | |
| PROM-related Variables | Date of PRO Data Collection | Date of PRO Data Collection |
| Mode of Collection | Mode of Collection | |
| Person Completing the Survey | Person Completing the Survey | |
| Generic PROM Version | N/A |
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