Providing high-quality care is more than marketing speak - it's an expectation. From risk-based contracts, to CMS regulations, to consumer demand, healthcare organizations need to do more than promise quality - they need to prove it. Leading healthcare organizations nationwide recognize the value of patient-reported outcomes data to deliver on this and several other clinical and operational objectives.
Why Patient-Reported Outcomes Data?
1. Quantify and Improve Clinical Value
Clinical quality improvement begins with understanding your baseline - being able to quantitatively and qualitatively define the current state of your care delivery. Patient-reported outcomes data enables healthcare organizations to:
Benchmark outcomes to identify areas of high and low value
Compare your performance against national averages and the competition
Determine why certain interventions are more or less effective
Empower providers with data to inform treatment decisions
Enable the delivery of personalized medicine
Conduct this level of comprehensive assessment while saving time and reducing costs
2. Reduce Unnecessary Medical Spend
Unnecessary healthcare services cost an estimated $210 billion annually, according to the Institute of Medicine. Health systems can, and should, direct those funds to other areas that provide more value. For example, PRO data can help healthcare providers analyze which specific populations benefit from surgery and when a procedure may not be necessary at all.
3. Manage Risk
True quality care goes beyond the point of intervention to capturing patient progress in real time. This comprehensive picture is far easier to achieve with PRO data rather than relying solely on in-person follow-up visits. PRO data enables healthcare organizations to monitor patients more closely, to detect problems earlier, and identify those at risk of complications or readmission.
4. Improve the Patient Experience
An exceptional patient experience goes beyond what occurs at the point of care. How are you capturing patients’ voices to understand their perception of their care and outcomes? PRO data helps healthcare leaders measure patient satisfaction to support patient acquisition and retention strategies, and to ensure positive patient outcomes. After all, research shows patient satisfaction has a domino effect, influencing factors such as length of stay and readmission rates which drive the overall cost of care delivery and impact reimbursement
Additionally, PROs can improve communication between patients and physicians and encourage patient involvement by empowering them to speak up. Also, the data can be utilized at the point of care to involve patients in treatment decisions and deliver more personalized medicine.
5. Compete in the Competitive Healthcare Landscape
To stay viable in an increasingly competitive space, healthcare organizations need to be more intentional about demonstrating that they deliver high-quality care. A wide variety of competitors can influence patient leakage and loss of revenue, including:
Retailers such as CVS, Walgreens, and Amazon
Other health systems that are expanding and offering more services
Private equity investment groups that support independent practices
Collecting and leveraging patient-reported outcomes gives health systems an edge to improve patient retention and loyalty.
6. Meet Payer Demands
Quality of care, as measured by PROs, serves as the foundation of value-based care contracts, both with CKS and private payers. Patient-reported outcomes play a role in both prior authorization requirements and incentive programs such as the Merit-Based Incentive Payment System, which determines Medicare payment adjustments.
7. Meet Regulatory Requirements
Even outside of contracts, regulators are increasingly introducing metrics for better care at lower cost. Governing bodies are mandating PRO collection as part of efforts to improve healthcare quality and efficiency, reduce disparities, and lower costs. Hospitals that don’t collect and share patient-reported outcomes data to CKS will pay for it—in the form of reduced reimbursements starting in the 2028 fiscal year. Mandated PRO collection is picking up across medical specialties. For instance, starting in 2025, orthopedic providers will be required to report PRO data on certain hip and knee procedures to CKS, including information about patients’ pain levels, functional improvements, and mobility after surgery.