Testing of a Risk-Standardized Complication Rate Electronic Clinical Quality Measure (eCQM) for Total Hip and/or Total Knee Arthroplasty.
Mica Curtin-Bowena, Troy Lia, Avery Pullmana, Alexandra Busingera, Stuart R. Lipsitza b, Ania Syrowatkaa, Michael Sainlairea, Tien Thaia, Jay R. Liebermanc, Aileen M. Davisd, Bonnie B. Blanchfielda e, David Westfall Batesa b, Patricia C. Dykesa b
- aBrigham and Women's Hospital, Boston, MA
- bHarvard Medical School, Boston, MA
- cKeck School of Medicine, The University of Southern California, Los Angeles, CA
- dUniversity of Toronto, Ontario, CA
- eHarvard T.H. Chan School of Public Health, Boston, MA
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Abstract
Supported by the Centers for Medicare & Medicaid Services (CMS), Brigham and Women's Hospital (BWH) has retooled the existing claims-based measures NQF1550 and NQF3493 into an electronic clinical quality measure (eCQM) to assess the risk-standardized complication rate (RSCR) following elective primary total hip (THA) and knee arthroplasty (TKA) at the clinician group level. This novel eCQM includes risk-adjustment for social determinants of health, includes all adult patients from all payers, leverages electronic health records (EHRs) rather than claims-based data, and includes both inpatient and outpatient procedures and complications which offers benefits compared to existing metrics. Following testing in two geographically different healthcare systems, the overall risk-standardized complication rate within 90 days following THA and TKA at the two sites was 3.60% (Site 1) and 3.70% (Site 2). This measure is designed for use in the Merit-Based Incentive Payment System (MIPS).