American Joint Replacement Registry Prior Authorization Pilot

How to Get Greenlighted for Your Total Joint Procedures for 2023: A Surgeon’s Guide

The AAOS Registry Program has partnered with Cohere Health, a digital health company with a collaboration platform for digital prior authorizations, on a new pilot. The goal of the pilot is to allow AAOS American Joint Replacement Registry (AJRR) participants to track their performance against key quality metrics to qualify for Humana patient population greenlighting: a full waiver of prior authorizations for total hip and knee arthroplasties for a year.

1. Contact Our Engagement Team
   - Current AJRR Surgeons - Have your site Authorized User* reach out to RegistryEngagement@aaos.org and sign a data sharing agreement so we can provide your aggregate, deidentified performance measures to Cohere
   *Our team can connect you with your site Authorized User
   
   - Future AJRR Surgeons - you or your site’s administrator can also reach out to the above email to find out more about the Registry and start contracting
   
   
2. Data Submission
   - Current AJRR Surgeons - Encourage your site to submit at least quarterly data on your total joint procedures and any 90-day readmissions and patient-reported outcomes for the cases
   
   - Future AJRR Surgeons - During initial report creation, provide clinical support for data or technology team questions as needed to identify procedural element documentation location and ensure efficient extraction
   
   
3. Performance Measure Review
   Log in to your Surgeon Dashboard on RegistryInsights® to review performance data for pilot metrics*
   1. 90-Day Readmission
   2. Discharged to Home
   3. Preoperative Functional/Health Status Assessment
   4. Postoperative Functional/Health Status Assessment
      *These are being calculated and reported at the individual surgeon level
      
      
4. Scorecard Approval
   - Our Registry team will reach out when your data is ready for quarterly submission and request approval to send to Cohere
   
   - If discrepancies are noted, AAOS Registry staff will work with your data submission contact to correct or resubmit data
   
   
5. Greenlighting Determination
   Cohere reviews surgeon scorecards on a quarterly basis and provides greenlighting determination on an annual basis