What is the financial penalty for not reporting 50% of all eligible patients?
CMS will reduce 25% of the Annual Payment Update (usually 2-4%) for ALL the hospital’s Medicare Fee-for-Service Part A claims, including orthopedic claims. Additionally, the hospital will be disqualified from participation in all Medicare value-based purchasing programs.
How are hospitals being scored?
CMS will publicly report on the total percentage of patients that achieve a substantial clinical benefit (
SCB) from THA/TKA surgeries based on the submitted data.
When do I need to start collecting baseline data and PROMs?
Preoperative data needs to be captured for procedures performed beginning July 1, 2024.
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