Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
J Bone Joint Surg Am. 2024 Jul 3;106(13):1233-1241. doi: 10.2106/JBJS.23.01013. Epub 2024 Feb 9.
The Centers for Medicare & Medicaid Services (CMS) has finalized a landmark national policy to standardize and expand the collection and reporting of patient-reported outcome measures (PROMs) following total hip arthroplasty (THA) and total knee arthroplasty (TKA). This policy will be rolled out through phased implementation, beginning with voluntary reporting starting in 2023 and transitioning to mandatory reporting starting in 2025, which will be tied to hospital payment determinations in fiscal year 2028. The overarching goal of this policy is to gather meaningful pre- and postoperative PROM data directly from patients to enhance clinical care, shared decision-making, and quality measurement for these common elective procedures. This national initiative underscores the value of incorporating patient perspectives and priorities into assessments of surgical care quality. For orthopaedic surgeons and hospitals, participating in the initial voluntary reporting period provides an opportunity to integrate PROM collection into clinical workflows and to leverage these data to improve patient care. The achievement of robust PROM response rates and a strong performance on the underlying THA/TKA Patient-Reported Outcome-Based Performance Measure may have increasing relevance as payment models shift toward value-based care. The aim of the present forum was to provide an in-depth review of this new CMS policy and key details regarding required PROM instruments, data-collection time frames, and other specifications that surgical teams should understand as they prepare for implementation. The goal was to equip orthopaedic surgeons with actionable information as they embark on this new era of national PROM collection and reporting.
医疗保险和医疗补助服务中心 (CMS) 最终确定了一项具有里程碑意义的国家政策,旨在标准化和扩大全髋关节置换术 (THA) 和全膝关节置换术 (TKA) 后患者报告结局测量 (PROM) 的采集和报告。该政策将通过分阶段实施推出,首先从 2023 年开始自愿报告,然后从 2025 年开始强制报告,这将与 2028 财年的医院支付决定挂钩。该政策的总体目标是直接从患者那里收集有意义的术前和术后 PROM 数据,以改善这些常见择期手术的临床护理、共同决策和质量衡量。这一国家倡议强调了将患者观点和优先事项纳入手术护理质量评估的重要性。对于骨科医生和医院来说,参与初始自愿报告期为将 PROM 收集纳入临床工作流程并利用这些数据改善患者护理提供了机会。在支付模式向基于价值的护理转变的情况下,实现强大的 PROM 响应率和在 THA/TKA 患者报告基于结果的绩效衡量标准方面的出色表现可能会越来越重要。本次论坛的目的是深入审查这一新的 CMS 政策,以及有关必需的 PROM 工具、数据收集时间框架和其他规格的关键细节,这些都是手术团队在为实施做准备时应了解的。目标是为骨科医生提供可操作的信息,因为他们开始进入这个国家 PROM 采集和报告的新时代。