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ASC-21 Rule by CMS is Coming: J.L. Morgan and Associates Can Help You Be Prepared!

The healthcare landscape continues to evolve, and the recent finalization of the ASC-21 rule by the Centers for Medicare & Medicaid Services (CMS) reflects a growing emphasis on patient-reported outcomes (PROs). This rule introduces the Risk-Standardized Patient-Reported Outcome-Based Performance Measure (THA/TKA PRO-PM) to both the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) payment system.


The Centers for Medicare and Medicaid Services (CMS) finalized the ASC-21 rule which includes the addition of the Risk-Standardized Patient-Reported Outcome-Based Performance Measure (THA/TKA PRO-PM) to both the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) payment system. This final rule emphasizes the importance of utilizing patient-reported outcomes in care delivery by bringing the PRO-PM measure to the outpatient setting.


Starting October 3rd, 2024, providers may begin to collect data for the first round of voluntary reporting. Participating in voluntary reporting ensures you have enough time to test and refine your workflows prior to mandatory deadlines with payment impacts.‍


What You Need to Know About THA/TKA PRO-PM

The THA/TKA PRO-PM is a new performance measure that utilizes standardized patient-reported outcome surveys to assess a patient's progress following THA or TKA surgery.  This data will be used to evaluate the effectiveness of care provided by hospitals and ASCs.

The good news is that voluntary reporting for the THA/TKA PRO-PM begins on October 3rd, 2024. This provides a valuable opportunity for healthcare providers to:

  • Test and refine their data collection workflows.

  • Ensure they are prepared for mandatory reporting deadlines.

  • Gain valuable insights into patient outcomes.


J.L. Morgan and Associates Can Be Your Partner in PRO-PM Success

At J.L. Morgan and Associates, we understand the complexities of implementing new performance measures.  We have extensive experience in helping healthcare providers navigate the ever-changing regulatory environment.

Our team can assist you with:

  • Understanding the THA/TKA PRO-PM requirements.

  • Developing a comprehensive data collection plan.

  • Selecting and implementing appropriate PRO surveys.

  • Ensuring accurate and timely data submission.


Taking Action Now Makes a Difference

Voluntary reporting for the THA/TKA PRO-PM offers a strategic advantage. By participating early, you can streamline your processes and be fully prepared for mandatory reporting, which will ultimately impact your reimbursement.


Don't wait – contact J.L. Morgan and Associates today!  We can help you navigate the THA/TKA PRO-PM and ensure you are well-positioned to deliver exceptional patient care while meeting the latest quality measurement requirements.



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Surgery Center

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