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Preparing for the Outpatient CMS THA/TKA PRO-PM

Preparing for the Outpatient CMS THA/TKA PRO-PM

Key Takeaways

  • The pre-procedure collection window for voluntary reporting of the outpatient THA/TKA PRO-PM begins in October

  • There are financial implications for failing to report the necessary data

  • There are financial implications for failing to meet specific improvement metrics

  • PatientIQ is providing free consultations to assess the cost of non-compliance on your organization and ensure you have the building blocks in place to meet the CMS requirements.

In November 2023, the Centers for Medicare & Medicaid Services (CMS) finalized its rule mandating reporting of the patient-reported outcome-based performance measure (PRO-PM) following total hip and knee arthroplasty (THA/TKA) in both the Hospital Outpatient Quality Reporting (OQR) and ASC Quality Reporting (ASCQR) programs.

This follows CMS introducing the THA/TKA PRO-PM in the Hospital Inpatient Quality Reporting (IQR) program in 2022 (of which the first mandatory collection period is about to begin).

The 2025 reporting pre-procedure collection window begins on October 3rd, 2024, and there are a few key requirements to keep in mind.


Reporting requirements at a glance

To avoid financial penalties, providers must report the following to CMS:

  • A minimum of 45% of all eligible patients with complete pre-operative and post-operative data

  • A minimum 22 pt. improvement in HOOS, Jr. Scores

  • A minimum 20 pt. improvement in KOOS, Jr. Scores

And, for those that fail to report or meet the improvement metrics, there is a consequence: an average 2% reduction in annual payments.

To more accurately understand the financial impact on your organization, PatientIQ is offering free CMS consultations. In less than 30 minutes, you can receive a customized cost-impact analysis and outcomes program assessment.


Getting started

PatientIQ was built to automate the collection and analysis of patient outcomes data. From automating data collection to simplifying data export and delivering actionable insights, we can ensure you have the building blocks in place for CMS THA/TKA PRO-PM compliance.

Learn more with our free consultations.

Schedule your free CMS THA/TKA PRO-PM cost-impact consultation.


Schedule now

 

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