Quality measures play a substantial role in the Centers for Medicare and Medicaid Services' hospital payment and public reporting programs. The purpose of this study was to assess whether public measurement of total hip and knee arthroplasty risk-standardized readmission (RSRRs) and complication rates (RSCRs) was temporally associated with decreasing rates of adverse outcomes among Medicare beneficiaries. We evaluated annual trends in hospital-level risk-standardized complication and readmission rates in the fiscal years 2010–11 and 2016–17 for patients undergoing hospital-based inpatient hip/knee replacement procedures. We calculated hospital-level rates using the same measures and methodology used in public reporting. We examined annual trends in the distribution of hospital-level outcomes through density plots (similar to histograms).Introduction
Methods
Patient-reported outcome (PRO) data are variably collected before and after total hip/knee arthroplasty (THA/TKA). We assessed the generalizability of incentivized, prospectively collected PRO data for THA/TKA patient-reported outcome performance measure (PRO-PM) development. The Centers for Medicare & Medicaid Services (CMS) received PRO data voluntarily submitted by hospitals in a bundled payment model for THA/TKA procedures. Participating hospitals who collected and successfully submitted these data received an increase in their overall quality score, possibly resulting in a positive impact on model reconciliation payments. PRO data were collected from Medicare Fee-For-Service beneficiaries >= 65 years undergoing elective primary THA/TKA procedures from July 1 to August 31, 2016 at hospitals participating in the model. Pre-operative PRO and risk variable data were collected 0 – 90 days prior to surgery, while post-operative PRO data were collected 270 – 365 days following elective THA/TKA. PRO pre-op and post-op data were matched to Medicare claims data for determination of clinically eligible procedures and clinical comorbidities. We compared the characteristics of patients submitting PRO data to other elective primary THA/TKA recipients in the US.Introduction
Methods
