Do Medicare’s CJR Patient–Reported Outcome Measures Collection Windows Accurately Reflect Academic Clinical Practice?

Abstract Introduction The Comprehensive Care for Joint Replacement (CJR) mandates collection of patient–reported outcome measures (PROMs) for eligible total hip and total knee arthroplasty (THA and TKA) procedures during specific time periods that may not be attainable within routine academic practice. Methods We performed a retrospective analysis of prospectively collected PROM data from a 2017 cohort of primary THA and TKA patients who completed the PROMIS–10 global health survey in preoperative or postoperative time periods. The primary outcome was completion rates of PROMIS–10 per the CJR collection periods (90–0 days preoperative and 270–365 days postoperative) compared to an extended postoperative collection period of 270–396 days. Bivariate analysis and logistic regression were used to analyze the association between survey completion rates and patient characteristics. Results Of the 860 primary THAs and TKAs in 2017, 725 (84.3%) had preoperative surveys completed 90–0 days prior to surgery. Among the 725, 215 patients (29.7%) completed postoperative surveys within the CJR timeline of 270–365 days. Completion increased by 120 additional surveys (+16.5%) in the additional postoperative time period of 270–396 days (p 0.05 for all covariates). Conclusions In an academic clinical practice, completion rates of postoperative PROMs as part of routine clinical practice within the CJR mandated period was low for THA and TKA patients. CJR may consider additional time beyond 365 days to improve PROM completion rates.