On Nov. 19–20, the AAOS hosted its fifth annual Orthopaedic Quality Institute (OQI) in Washington, D.C. Organized by Council on Research and Quality Chair Kevin J. Bozic, MD, MBA, and Council on Advocacy Chair Thomas C. Barber, MD, the 2015 OQI focused on "Patient-Reported Outcomes in Orthopaedics."
The meeting aimed to achieve the following goals:
- identifying and understanding the value of disease-specific, domain-specific, and generic patient-reported outcome (PRO) measures in orthopaedics
- discussing the role of PROs in clinical practice
- identifying the barriers to and facilitators of PROs collection
- understanding the current and future use of PROs in accountability programs
- charting a course for AAOS involvement in facilitating PRO measure collection and use
PROs are an integral part of new payment incentive programs designed to control costs and increase quality. The U.S. Department of Health and Human Services aims to tie 30 percent of traditional fee-for-service Medicare payments to quality or value though alternative payment models (AMPs) or bundled payments by the end of 2016. Additionally, both the recent Physician Fee Schedule Final Rule and the new Comprehensive Care for Joint Replacement bundled-payment model discuss the use of PROs. (See cover story, "2016 Physician Fee Schedule Rule Finalized.")
The AAOS has a long history of commitment to the development and encouragement of best practices and evidence-based medicine; initiatives include developing clinical practice guidelines, appropriate use criteria, and performance measures.
The keynote presentation by David Cella, PhD, focused on the role of PROs in performance improvement, payment, and healthcare policy. Caleb Stowell, MD, from the International Consortium for Health Outcomes Measurement, spoke on why measuring PROs is essential to improving value. Finally, Kate Goodrich, MD, MHS, from the Centers for Medicare and Medicaid Services, shared the government's payer perspective, specifically the role of PRO measures.
Breakout sessions focused on the future of PROMs in clinical care and research, focusing on issues such as the use of PROs used in payment schemes, risk-adjustment, stakeholder engagement, and the most appropriate areas in orthopaedic for PROs in clinical practice. A summary of key presentations and breakout session results will be in the January 2016 issue of AAOS Now. More information on performance measures can be found in Advocacy Now, Headline News Now, and at www.aaos.org/measures