As regulatory requirements continue to expand and healthcare margins remain under pressure, health systems are being asked to do more with less while still proving the quality of care they deliver. Patient-reported outcomes (PROs) have become a critical part of this equation, serving as both a compliance requirement and a powerful tool for quality improvement.
PatientIQ was built to help health systems navigate this reality by making outcomes measurement reliable, scalable, and actionable.
The Growing Stakes of PRO-Based Reporting
Centers for Medicare & Medicaid Services (CMS) has made it clear that PROs are not a temporary initiative. Programs like the THA/TKA PRO-PM and the Information Transfer PRO-PM are part of a long-term shift toward outcomes-based accountability, with mandatory reporting periods already in place and additional specialty expansion planned through 2030.
Failing to meet these requirements can have significant consequences, including payment reductions and disqualification from value-based purchasing programs. At the same time, many organizations struggle with fragmented workflows, manual data collection, and limited visibility into whether compliance thresholds are being met.
As CMS continues to expand PRO-based reporting requirements across programs, quality leaders must be prepared not just to comply but to leverage outcomes data for system-wide improvement. This shift is especially evident in outpatient care, where clear instructions and seamless PRO capture are shaping the future of CMS Information Transfer reporting.
“PROs are here to stay. They're just going to continue to expand, and so hospitals really need to understand it's not just chasing the measure. It's really to optimize and use the measure to drive decision making evaluation, and really hear the voice of the patient involved in their care.”
— Deneen Ochab, Director of Quality & Patient Safety at Northwestern Medicine, speaking during PatientIQ's Becker's Healthcare webinar
Quality leaders are left asking the same question: how do we ensure compliance today while building a foundation that will scale tomorrow?
A Practical Framework for Quality and Compliance
PatientIQ supports health systems with a proven framework centered on three core actions: measure, analyze, and improve.
Measure Outcomes Effectively
PROs are essential for both regulatory compliance and continuous improvement. When collected consistently and at scale, PROs provide objective insight into treatment effectiveness and patient progress. As explored in this conversation between PatientIQ and a quality executive at a large academic medical center, outcomes data plays a central role in elevating quality initiatives across the health system.
PatientIQ’s ClinicalPRO automates PRO collection across procedures and timepoints, ensuring patients are enrolled in the right surveys at the right moments in their care journey. Automated outreach reduces staff burden while improving completion rates, helping organizations meet CMS requirements without adding manual work.
Because ClinicalPRO integrates directly with the EHR, outcomes data is captured accurately and consistently, creating a reliable source of truth for regulatory reporting.
Analyze Compliance in Real Time
Meeting compliance requirements requires more than collecting data. Health systems need visibility into performance across sites, procedures, and providers.
PatientIQ’s DataPRO provides real-time insight into PRO completion and performance, allowing teams to instantly see how many procedures meet or exceed compliance benchmarks. Quality teams can identify gaps early, track performance trends, and monitor readiness for both current and future CMS programs.
DataPRO also enables organizations to view provider-level performance and identify top performers, helping leaders understand where best practices are already working within their system.
Improve Through Targeted Action
True regulatory success comes from continuous improvement, not reactive reporting. PatientIQ helps organizations move from insight to action by highlighting at-risk patients, surfacing compliance issues before deadlines are missed, and enabling targeted interventions.
Quality officers are uniquely positioned to champion outcomes strategies that align clinical care, compliance, and performance improvement. This leadership role is increasingly critical as health systems look to standardize outcomes measurement across departments and specialties. As outlined in this blog, PROs provide the connective tissue between regulatory requirements and meaningful quality improvement
By combining ClinicalPRO automation with DataPRO analytics, health systems can adapt care plans, improve patient engagement, and strengthen outcomes while maintaining compliance.
Why This Approach Works
PatientIQ’s approach to quality and regulatory compliance is designed to reduce complexity, not add to it. Compliance is tracked in real time, visibility is immediate, and no full-time hires are required to manage reporting workflows.
Health systems benefit from higher PRO completion rates, improved data quality, and a clearer understanding of organizational performance. Just as importantly, they gain a scalable framework that supports future CMS programs, accreditation efforts, and system-wide quality improvement.
Compliance as a Foundation for Better Care
Regulatory compliance should not be treated as a checkbox exercise. When done well, it becomes a foundation for better decision-making, stronger patient engagement, and measurable improvements in care quality.
PatientIQ helps health systems turn PRO requirements into an opportunity to elevate care delivery while staying ahead of CMS mandates and future regulatory expansion. With automated workflows, real-time visibility, and actionable insights, organizations can achieve compliance with confidence while building a scalable outcomes strategy for the years ahead.
