CMS Compliance · PRO-PM · Value-Based Care

The CMS mandates are here. Your PRO program needs to be, too.

THA/TKA PRO-PM is mandatory for inpatient procedures. TEAM launches January 2026. Outpatient and ASC mandatory reporting hits in 2028. Outcomely ships the exact instruments, cadences, and exports CMS requires — without a managed-service contract.

2%
Potential APU reduction for non-reporting hospitals
50%
Minimum matched completion rate CMS requires (HOPD)
FY 2028
First payment determination using mandatory IQR PRO-PM data
Sources: CMS FY 2023 IPPS Final Rule · CMS CY 2024 OPPS/ASC Final Rule
The Financial Stakes

Reporting failure doesn't just cost hip and knee reimbursement. It costs your entire Medicare APU.

CMS applies PRO-PM penalties as pay-for-reporting, not pay-for-performance. That means you don't need to hit a specific outcome target — but if you miss the 50% matched completion rate, CMS reduces your hospital's entire Medicare Annual Payment Update. For a mid-size hospital, that's typically a seven-figure annual exposure, not a rounding error on one service line.

Inpatient (IQR program)
STATUS
Mandatory reporting active
FIRST IMPACT
FY 2028 APU
INSTRUMENTS
HOOS JR · KOOS JR
THRESHOLD
50% matched pre/post completion
Outpatient & ASC (OQR / ASCQR)
STATUS
Voluntary through CY 2026 · Mandatory CY 2027
FIRST IMPACT
2030 payment determination
INSTRUMENTS
HOOS JR · KOOS JR
THRESHOLD
50% HOPD · 45% ASC matched completion
TEAM Model
STATUS
Launches January 1, 2026
IMPACT
Mandatory bundled payment for selected hospitals
REQUIRED DATA
THA/TKA PRO-PM integrated into episode payment
CADENCE
Same pre/post cadence as IQR
Regulatory Runway

The CMS PRO-PM timeline, 2024 → 2030.

JULY 1, 2024
Mandatory
IQR PRO-PM mandatory reporting begins
JANUARY 1, 2025
Voluntary
Outpatient/ASC voluntary reporting starts
JANUARY 1, 2026
Mandatory
TEAM model launches
JANUARY 1, 2027
Mandatory
Outpatient/ASC mandatory reporting begins
FY 2028
Payment impact
First IQR payment determination using PRO-PM data
2030
Payment impact
First outpatient/ASC payment determination
Supported CMS Programs

Every CMS-mandated PRO measure. Pre-configured. Ready to submit.

Mandatory reporting active

THA/TKA PRO-PM (Inpatient — IQR)

What it is: CMS Hospital Inpatient Quality Reporting (IQR) program's mandatory PRO measure for elective primary total hip and knee arthroplasty. Assesses substantial clinical benefit (SCB) at one year post-op.

Required Instruments
  • HOOS JR (Hip disability and Osteoarthritis Outcome Score for Joint Replacement)
  • KOOS JR (Knee injury and Osteoarthritis Outcome Score for Joint Replacement)
  • Single Item Literacy Screener (SILS-2)
  • Patient-reported risk variables (contralateral joint pain, back pain, comorbidities)
Collection Windows
Pre-op: 0–90 days before procedure · Post-op: 300–425 days after procedure
Eligibility
Medicare FFS enrollees 65+, elective primary THA/TKA, enrolled in Medicare Parts A and B for 12 months prior.
Completion Threshold
50% matched pre-and-post completion required.
What Outcomely Does

Ships HOOS JR, KOOS JR, and SILS-2 as pre-built forms with correct scoring. Automates the 0–90 and 300–425 day collection windows. Tracks matched completion rates in real time. Exports data in HQR-compatible CSV and XML formats.

Voluntary — Mandatory CY 2027

THA/TKA PRO-PM (Outpatient — OQR / ASCQR)

What it is: Same measure, extended to Hospital Outpatient Departments (HOPDs) and Ambulatory Surgical Centers (ASCs). Reflects the shift of THA/TKA procedures to outpatient settings after CMS removed them from the inpatient-only list.

Required Instruments
  • HOOS JR · KOOS JR · SILS-2 · risk variables (same as IQR)
Collection Windows
Same as IQR (0–90 pre-op, 300–425 post-op)
Completion Threshold
50% for HOPDs · 45% for ASCs.
Key Dates
  • Voluntary period 1: procedures CY 2025 — pre-op due May 15, 2026, post-op due May 15, 2027
  • Voluntary period 2: procedures CY 2026 — pre-op due May 15, 2027, post-op due May 15, 2028
  • Mandatory: procedures CY 2027 onward, impacting 2030 payment determination
What Outcomely Does

Same instrument library as IQR, plus HOPD/ASC-specific workflows that account for the different completion thresholds and submission portals (HQR for HOPD, ASCQR for ASC).

Launches January 1, 2026

TEAM Model

What it is: Transforming Episode Accountability Model — CMS's mandatory bundled payment model for selected hospitals. Pays hospitals a single, pre-determined amount for the 30-day episode of care around specific surgical procedures (including THA/TKA). Integrates PRO-PM data directly into episode payment.

Notes
  • How PROs fit: Hospitals in TEAM must collect THA/TKA PRO-PM data as part of episode reporting. Failure to report affects the episode reconciliation payment, compounding the APU exposure from IQR.
What Outcomely Does

If your hospital is in the TEAM cohort, you're already on the hook for IQR PRO-PM. Outcomely's PRO-PM workflows satisfy both. TEAM-specific episode reporting fields are flagged in the dashboard so your quality team can track episode-level completion.

Eligible clinicians

MIPS Quality Measures

What it is: Merit-based Incentive Payment System — the Medicare Part B physician payment program that includes dozens of specialty-specific PRO measures as quality measures.

Notes
  • Measure #459 — Back Pain After Lumbar Surgery
  • Measure #460 — Back Pain After Lumbar Fusion
  • Measure #461 — Leg Pain After Lumbar Surgery
  • Depression screening (PHQ-9)
  • Functional outcomes for orthopedic procedures
What Outcomely Does

Ships common MIPS PRO measures as pre-built forms. Tracks completion rates needed for MIPS reporting thresholds. Exports MIPS-compatible data for registry or direct submission.

How It Works for PRO-PM

A PRO-PM workflow you can actually trust.

Built around the exact CMS collection windows, instrument specifications, and submission formats. No custom configuration required.

01
Identify eligible procedures

Your ortho team flags elective primary THA/TKA procedures for Medicare FFS patients 65+. Import from your scheduling system or tag manually.

02
Pre-op collection (0–90 days)

Outcomely automatically schedules HOOS JR or KOOS JR plus risk-variable questions within the 0–90 day window. Token-based patient links, SMS and email delivery.

03
Procedure day

Procedure performed. Pre-op data already captured and scored. No gap in the workflow.

04
Post-op collection (300–425 days)

Post-op HOOS JR or KOOS JR automatically scheduled in the 300–425 day window. Reminder cadence optimized for the 50% matched completion threshold.

05
Matching and scoring

Pre- and post-op responses automatically matched at the patient level. SCB (substantial clinical benefit) calculated per CMS specification.

06
HQR-ready export

Export in CMS HQR-compatible CSV or XML format. Submit directly, or hand off to your registry vendor (AJRR, AAOS RegistryInsights).

Important: Outcomely produces the data and the export. Final submission to the HQR portal is performed by your hospital's designated submitter (or via a partner registry like AJRR). We do not submit on your behalf — this intentional separation keeps the hospital in control of its submissions and regulatory relationship.
The Honest Comparison

We don't pretend to be a managed service. Here's exactly where we fit.

Outcomely Handles
  • Pre-built HOOS JR, KOOS JR, SILS-2, and risk variables
  • Automated pre-op (0–90d) and post-op (300–425d) scheduling
  • Patient-facing mobile-friendly forms with SMS and email delivery
  • Automated SCB calculation per CMS specification
  • Real-time matched completion rate tracking
  • HQR-compatible CSV and XML export formats
  • AJRR-compatible data structures for registry submission
  • Dashboards for your quality team
You Still Own
  • Final submission to the CMS HQR portal
  • Designation of your hospital's CMS submitter contact
  • Registry relationships (AJRR, AAOS) if you use one
  • Medicare Beneficiary Identifier (MBI) sourcing from your billing system
  • CMS audit response if requested
  • Hospital-level decisions about patient inclusion edge cases

Managed-service vendors like CODE Technology or Medisolv take on these hospital-owned responsibilities as part of their contracts. Outcomely is designed for teams that want to keep that control and ownership. Many hospitals pair Outcomely for the workflow layer with a light-touch submission partner for the regulatory relationship — which typically costs a fraction of a full managed-service contract.

When Self-Serve Wins

The right tool depends on who owns the program.

Academic medical centers

Research teams and quality departments that want to own the outcomes program internally, share data across studies, and avoid the lock-in of multi-year managed-service contracts. Outcomely fits here.

Specialty orthopedic groups

Mid-size practices and ASCs where a $50K+/year managed-service contract is overkill but compliance still matters. Outcomely fits here.

Innovation and digital health teams

Hospital innovation groups running pilots, evaluating AI-assisted workflows, or standing up programs faster than enterprise procurement allows. Outcomely fits here.

Where managed services still win: Large health systems running orthopedic programs across dozens of sites with zero internal operational capacity. If your team can't take on any of the "you still own" list above, a managed-service vendor is the right call.

CMS-Specific Questions

The questions hospital quality leaders ask.

Don't wait for FY 2028 to find out your reporting was short.

Start a free pilot with synthetic data. See the full PRO-PM workflow in under 10 minutes. We'll walk your team through HOOS JR, KOOS JR, and the CMS export — no sales pressure, no procurement cycle.

No credit card · HIPAA-ready architecture · BAA available for production