The Centers for Medicare & Medicaid Services (CMS) has introduced patient-reported outcome performance measures (PRO-PMs) into its quality reporting programs, starting with total hip arthroplasty (THA) and total knee arthroplasty (TKA). These measures reflect CMS’s broader shift toward evaluating outcomes from the patient’s perspective, not just clinical results documented in the chart.
The THA/TKA PRO-PM is already in place under the Hospital Inpatient Quality Reporting (IQR) Program and is scheduled to become publicly reportable in 2027. To meet the requirements, hospitals must collect pre- and post-operative data directly from patients using a CMS-approved instrument. CMS has made it clear that this is the first of several condition-specific PRO-PMs being developed [¹].
The expansion of the CMS PRO-PM initiative signals a long-term move toward outcome-based accountability tied directly to the patient experience.
The timeline for CMS’s THA/TKA PRO-PM gives hospitals time to build and refine their collection process. But once scores become publicly reported in 2027, the focus shifts. PRO performance will appear on Care Compare, where patients, payers, and referring providers can see how hospitals measure up.
Public reporting introduces competitive pressure. Hospitals without a consistent approach to PRO collection may be at risk of submitting incomplete data or falling behind peers. The results will reflect both clinical outcomes and the reliability of each hospital’s PRO workflows.
Taking action now gives teams time to address process gaps, test tools, and submit accurate data that reflects true performance.
The THA/TKA measure is CMS’s first formal PRO-PM, but it likely will not be the last. CMS has indicated that additional PRO-PMs are in development across other areas of care [²]. While details have not been finalized, future measures may focus on procedures where patient input is relevant to evaluating recovery and functional outcomes.
This aligns with CMS’s broader move toward value-based care, where patient experience and outcomes carry more weight in assessing performance. Hospitals may need to expand their ability to collect and report standardized PRO data across multiple specialties over time.
Planning early can help organizations stay ahead as new measures are introduced and expectations continue to evolve.
To participate in the THA/TKA PRO-PM under the Hospital Inpatient Quality Reporting (IQR) Program, hospitals must meet several technical and operational requirements. These include:
Eligible procedures: The measure applies to inpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures performed on Medicare beneficiaries.
Timing of data collection: PROs must be collected both before surgery (within 90 days prior to the procedure) and after surgery (between 270 and 365 days following the procedure).
Instruments used: Hospitals must use CMS-approved instruments for both the condition-specific and general health assessments. Examples include HOOS JR or KOOS JR for joint-specific function.
Data submission: Data must be submitted in a standardized format through the hospital’s EHR or a CMS-approved submission pathway. The final data set must include both pre- and post-operative responses to be considered complete.
Hospitals that do not submit complete data may not meet program requirements, which could affect overall IQR compliance once the measure becomes publicly reported in 2027.
Meeting CMS requirements on paper is one thing. Delivering accurate, reliable PRO data at scale is another. Hospitals that prepare early will be better positioned when scores become public in 2027.
Start by reviewing current workflows. Focus on these steps:
Preparing for the CMS PRO-PM now is more than a compliance exercise. Hospitals that build effective PRO workflows early gain experience, uncover gaps, and create a stronger foundation for long-term measurement. The process takes time, especially when it involves multiple departments, technology systems, and patient touchpoints.
Getting ahead also creates an opportunity to use the data beyond reporting. Health systems that collect PROs at scale can compare results across service lines, identify patterns in recovery, and evaluate performance over time. These insights can support clinical improvement, patient communication, and operational planning.
As more PRO-PMs are introduced, organizations that already have systems in place will be able to adapt faster and respond with confidence.
PatientIQ provides a platform built to support hospitals through every stage of PRO collection and reporting. The system automates the delivery of CMS-approved surveys like HOOS JR and KOOS JR, schedules them at the correct pre- and post-operative intervals, and captures responses electronically. This removes manual steps and helps improve completion rates.
Data flows directly into the EHR or can be accessed through PatientIQ’s dashboard, allowing teams to monitor progress, check compliance, and review response quality in real time. Built-in analytics tools help identify gaps and support internal reporting, while standardized formats align with CMS requirements for submission.
Because PatientIQ is designed for system-wide use, it scales easily from individual service lines to enterprise-wide initiatives. Hospitals using PatientIQ can collect PROs more consistently, reduce administrative workload, and stay aligned with current and future PRO-PM requirements.
The shift to PRO-based performance measures is underway, and 2027 is a clear milestone. Hospitals that treat this as a long-term strategy, not a short-term requirement, will be better positioned to adapt as expectations evolve.
Building internal capacity now allows teams to improve processes over time, rather than rushing to react when scores go public. The goal isn’t just to report data, but to use it in ways that strengthen care and support accountability.
Request a demo to see how PatientIQ helps hospitals take the next step in PRO readiness.
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