2024 Performance PeriodCMS56v12Not Applicable376Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery

]]>

None

]]>

Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between November of the year prior to the measurement period and the end of the measurement period

]]>

Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure

]]>

Not Applicable

]]>

Equals Initial Population

]]>

Exclude patients who are in hospice care for any part of the measurement period.

Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period.

Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty.

Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty.

Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty.

Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty.

Exclude patients with a mechanical complication on the day of the total hip arthroplasty.

Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure.

Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after.

]]>

None

]]>Centers for Medicare & Medicaid Services (CMS)]]>Proportion]]>Process]]>

A higher score indicates better quality

]]>The same FSA instrument must be used for the initial and follow-up assessment.This eCQM is a patient-based measure.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.Yes

THAs are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for older adults, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006).

This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock, 2010).

]]>

None

]]>

None

]]>

While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015).

Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick, 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/TKA (Gkiatas, 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard, 2021).

Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin, 2021) (Holte, 2021).

]]>2025 Performance PeriodCMS56v13Not Applicable376Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery

]]>None

]]>Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period

]]>Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure

]]>Not Applicable

]]>Equals Initial Population

]]>Exclude patients who are in hospice care for any part of the measurement period.

Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period.

Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty.

Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty.

Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty.

Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty.

Exclude patients with a mechanical complication on the day of the total hip arthroplasty.

Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure.

Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after.

]]>None

]]>Centers for Medicare & Medicaid Services (CMS)]]>Proportion]]>Process]]>A higher score indicates better quality

]]>The same FSA instrument must be used for the initial and follow-up assessment.This eCQM is a patient-based measure.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.YesTHAs are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for older adults, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006).

This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock et al., 2010).

]]>None

]]>None

]]>While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015).

Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021).

Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021).

]]>2026 Performance PeriodCMS56v14Not Applicable376Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery

]]>None

]]>Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period

]]>Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure

]]>None

]]>Equals Initial Population

]]>Exclude patients who are in hospice care or have a hospice care order documented during any part of the measurement period.

Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period.

Exclude patients with one or more specific lower body fractures indicating trauma in the 48 hours before or at the start of the total hip arthroplasty.

Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty.

Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty.

Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty.

Exclude patients with a mechanical complication on the day of the total hip arthroplasty.

Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure.

Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after.

]]>None

]]>Centers for Medicare & Medicaid Services (CMS)]]>Proportion]]>Process]]>Higher score indicates better quality

]]>The same FSA instrument must be used for the initial and follow-up assessment.This eCQM is a patient-based measure.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.YesTHAs are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for older adults, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006).

This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock et al., 2010).

]]>None

]]>None

]]>While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015).

Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021).

Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021).

]]>