Beyond HCAHPS, Patient Surveys Dig Into Functional Outcomes
The change is coming gradually, in the form of specialty disease or procedure measure questionnaires such as WOMAC (the Western Ontario and McMaster Universities Arthritis Index), OMERACT (Outcome Measures in Rheumatology), and CCORP, (the California Clinical Registry for Orthopedic Procedures) a fledging effort that specifically includes patient self-reported functional outcomes after joint replacement surgeries.
There's also the SF-36 (Short Form-36) and the VR-12 (Veterans Rand 12-item Health Survey). And there are many mental status surveys that attempt to measure depression and fatigue. For Medicare Managed Care Patients, there's the federal Health Outcomes Survey. Some of these have been around for awhile, but recently, they're being adapted for new uses.
Now, there are overt signs that federal regulators want to do more to link such self-assessment surveys to incentive payments. Indeed, in the Centers for Medicare & Medicaid Services' proposed Meaningful Use rule stage 2, providers are being asked to attest that they obtained "patient reported" functional assessments both at baseline, (about 180 days before), and 60 days after undergoing any of three procedures or episodes of care:
- Total knee arthroplasty, for patients 18 years of age and older
- Total hip arthroplasty, for patients 18 years of age and older
- Care for patients with congestive heart failure who also have two or more high impact conditions, for patients 65 years of age and older.
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