Patient Report Outcomes (PRO) Data Collection and ...

Patient Reported Outcomes (PRO) Data Collection and Submission: Updates for Performance Years 6 - 8 (PYs 6 - 8)

Comprehensive Care for Joint Replacement Model


August 18, 2021

Audio is available through device speakers

Webinar Agenda

• Welcome and Logistics • Introduction• Overview of Model Updates

– What has changed – What hasn’t changed

• PY 6 Resources • Demonstrations

– PY 5 HSR – Data Collection Template

• Announcements and Reminders

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Comprehensive Care for Joint Replacement Model 5

Introduction

Kristina Burkholder Project Lead

Yale New Haven Health Services Corporation/Center for Outcomes Research & Evaluation (YNHHSC/CORE)


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Overview of Model Updates

• Model extended for three additional Performance Years (PYs) and will continue to December 31, 2024. – See https://innovation.cms.gov/innovation-models/cjr for

final rule. • Goals of the CJR model are unchanged. • Includes changes to several aspects of the CJR

program, including a few changes which impact PRO and risk variable data collection.

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https://innovation.cms.gov/innovation-models/cjr

Overview of CJR PRO Updates


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What Has Changed?

• Who is eligible to report • Procedure dates & collection periods • Post - op data collection length (extended 2

months) • Submission deadlines • Thresholds

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Who is Eligible to Report?

• Hospitals in the 34 mandatory reporting MSAs – Full list available here:


• Hospitals in the other 33 MSAs and rural/small hospitals who were previously voluntary participants in the CJR program are no longer eligible



Procedure Dates & Collection Periods

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Pro Data Collections and Submission Periods

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Performance Years

Procedure Window

Pre - Op Data Collection

Post - Op Data Collection

Data Submission

PY 5 7/1/19 to 6/30/20 4/1/19 to 6/30/20 4/1/19 to 6/30/20 7/1/20 - 8/31/20

PY 6 7/1/21 to 6/30/22 4/1/21 to 6/30/22

4/1/20 to 8/31/21 (For PY 5

procedures)7/1/22-8/31/22

PY 7 7/1/22 to 6/30/23 4/1/22 to 6/30/23

4/1/22 to 8/31/23 (for PY 6

Procedures) 8/1/23 - 9/30/23

PY 8 7/1/23 to 6/30/24 4/1/23 to 6/30/24

4/1/23 to 8/31/24 (For PY 7

Procedures)8/1/24-9/30/24

NO PRO Data Submission in 2021

Model Extension Details- Thresholds

PY Eligible THA/TKA Procedures Performed During PRO and Risk Variable Submission Requirements

6 July 1, 2019- June 30, 2020POST - operative data on THA/TKA procedures for ≥ 80% or 200 procedures (post-op data must match to pre-op PROs submitted in PY 5)

6 July 1, 2021 – June 30, 2022 PRE-operative data on THA/TKA procedures for ≥ 80% or 300 procedures

7 July 1, 2021 – June 30, 2022POST - operative data on THA/TKA procedures for ≥ 80% or 300 procedures (post-op data must match to pre-op PROs submitted in PY 6)

7 July 1, 2022 – June 30, 2023 PRE - operative data on primary elective THA/TKA procedures for ≥ 85% or 400 procedures

8 July 1, 2022 – June 30, 2023POST - operative data on primary elective THA/TKA procedures for ≥ 85% or 400 procedures (post-op data must match to pre-op PROs submitted in PY 7)

8 July 1, 2023 – June 30, 2024 PRE - operative data on primary elective THA/TKA procedures for ≥ 90% or 500 procedures

What Has Not Changed

• Required PRO and risk variable data • Eligible procedures • 2 bonus points for Quality Composite

Score

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Required PRO and Risk Variable Data Required pre - and post - operative PRO instruments

•VR - 12 OR PROMIS Global PROMs; AND • HOOS/KOOS JR . OR HOOS/KOOS subscales • HOOS subscales: pain and function, daily living •KOOS subscales: stiffness, pain, and function, daily living

Required identifiers with all (pre - and post - operative) submitted data

•Medicare Health Insurance Claim Number [HICN], Railroad Retirement Board Medicare Number, or Medicare BeneficiaryIdentifier [MBI])•Date of Birth

Required risk variables with pre - operative submitted data only

•Race and Ethnicity•Body mass index (BMI) or Height (cm) and Weight (kg)•Patient-reported Health Literacy Screening (SILS2) Questionnaire

•Pre-operative Use of Narcotics• Patient - reported Pain in Non-operativeLower Extremity Joint •Patient-reported Back Pain (Oswestry Index Question)

Required identifiers with post - operative submitted data only

•Date of Admission •Date of Procedure

Requested variables with pre - and post - operative submitted data

•Medicare Provider Number (CMS Certification Number, or CCN)•Performance Year

•Survey Respondent (if not patient)•Date of Collection•Mode of Collection

Pre-Operative Collection


Post-Operative Collection


Eligible Procedures

• Patient is receiving inpatient care at participating CJR hospital

• Undergoing elective primary THA/TKA procedure (includes bilaterals )

• Procedure is not a revision • Patient does not have femur, hip, or pelvis

fractures • Patient does not have cancer • Patient not undergoing simultaneous removal of

implanted devices/prostheses • Not a mechanical complication of prior THA/TKA • Aged 65 or older and enrolled in Medicare FFS

See Patient Selection Flowchart for Determining Eligible Elective Primary THA/TKA Procedures figure

PY 6 Resources

Overview • PY 6 CJR PRO Data Collection Overview • PY 6 CJR PRO Performance Year 6 Overview

Data collection • PY 6 CJR PRO Data Collection Template **New Location**

• Download from CJR Model Site: https://innovation.cms.gov/innovation-models/cjr• PY 6 CJR PRO Data Collection Template User Guide • PY 6 CJR PRO Data Dictionary • PY 6 CJR PRO Data Dictionary User Guide

Data Submission • PY 6 CJR HARP Registration Instructions • PY 6 CJR PRO Guidance for Managed File Transfer • PY 6 CJR PRO Managed File Transfer Instructions

PY 6 CJR PRO Data Collection FAQSPY 6 PRO resources (except template) can continue to be found on CMMI Connect: https://app.innovation.cms.gov/CMMIConnect/

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https://app.innovation.cms.gov/CMMIConnect/

Demonstration – HSR


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Resources - HSR

READ ME PAGE

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Resources - HSR

PRO SUBMISSION PERFORMANCE PAGE

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Resources - HSR

PY 4 PRE-OP PAGE

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Resources - HSR

PY 5 POST-OP FOR PY4 PROCEDURES PAGE

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Resources - HSR

PY5 PRE-OP PAGE

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Demo Data Collection Template


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Data Collection Template


Questions

• Use the Q&A pod to submit any questions

• Please use “@” if question is directed to one presenter

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Announcements and Reminders

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Reminders

• Send any follow - up or unanswered questions from this event to [email protected].

• If your organization has made any changes to your points of contact for the CJR model, please email [email protected] to request a Data Request and Attestation (DRA) form which should be submitted through the Data Portal (preferred) or through encrypted email.

• To request a CJR Connect account, go to: https://app.innovation.cms.gov/CMMIConnect/IDMLogin and click “New User Registration”.

• Please take a few minutes to complete the Post - Event Survey.


mailto:[email protected]

mailto:[email protected]

https://app.innovation.cms.gov/CMMIConnect/IDMLogin

Patient Report Outcomes (PRO) Data Collection and ...

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