Authors: Manjot Singh, Zaid Al Nassir, Joyce Harary, Wayne E. Moschetti
Abstract
Introduction
As part of quality reporting programs, Centers for Medicare & Medicaid Services (CMS) requires hospitals to submit preoperative/matching postoperative patientreported outcome measures (PROMs) for at least 50% of their total hip arthroplasty (THA)/total knee arthroplasty (TKA) inpatients. The present study examines if a specialized digital musculoskeletal (MSK) care management platform is sufficient to comply with CMS requirements and achieve substantial clinical benefit (SCB).
Methods
TKA/THA patients ages 65 years and older who underwent surgery at a tertiary academic medical center between November 2018 to May 2023 were included. HOOS Jr, KOOS Jr, VR-12, and PROMIS Global scores were collected preoperatively and oneyear postoperatively through the digital platform. Compliance was measured as the proportion of patients completing the HOOS JR. or KOOS Jr. at both time points, as well as the proportion of patients completing either VR-12 or PROMIS Global preoperatively. Improvement in scores was compared to the SCB defined by CMS. All data extraction and analyses were conducted using Looker and Excel.
Results
Among 1,290 TKA and 1,109 THA, 89.1% TKA and 82.4% THA patients opted into using the platform. Of the TKA cases, 64.7% completed KOOS Jr at both time points and 82.7% completed either VR-12 or PROMIS Global preoperatively. Of the THA cases, 57.4% completed HOOS Jr at both time points and 74.4% completed either VR-12 or PROMIS Global preoperatively. Finally, of those that completed PROMs at both time points, 59.5% TKA and 75.0% THA patients met the CMS-defined SCB of 20 and 22 points, respectively.
Conclusion
As CMS increasingly requires the collection of PROMs in quality reporting programs and episode-based payment models, PROMs collection through a specialized digital platform may sufficiently meet the current CMS requirements. Further investigation may be warranted to compare achievement of SCB thresholds in patient groups not utilizing comprehensive digital care.
