Why Strategic Organizations Are Prioritizing Patient-Reported Outcomes

Healthcare organizations can no longer afford to treat outcome data as an afterthought.

Smiling older woman with gray hair and orange glasses uses a smartphone, wearing a yellow cardigan, with a green circle background—illustrating how patient-reported outcome measures (PROMs) empower individuals to actively participate in their healthcare.

The Growing Value of the Patient Voice

CMS made PROs mandatory. Other payers are following suit.

Hospitals are now required to collect pre and 1 year post op PROM data on hip and knee replacement patients. Commercial payers are expanding their use of outcome data through quality programs like Blue Distinction, value-based payment models, and prior authorization requirements. Organizations need sustainable systems that can adapt as expectations continue to grow.

The financial stakes are specific, large, and calculable.

Hospitals that fail to meet the 50% THA/TKA PRO-PM survey capture requirement face a 25% reduction in their Medicare Annual Payment Update (APU) – a penalty your CFO can calculate down to the dollar. For large health systems, the financial exposure can reach into the millions. At the same time, PROMs are increasingly tied to quality composite scores in value-based payment models like TEAM, making outcome data a financial asset.

The window to get ahead is closing.

Organizations that understand their outcomes first are the ones that lead.

Payers are gaining access to more PROM data than ever before – and providers and healthcare organizations alike need to understand what the payers are seeing, before it is publicly reported. Oftentimes the payers report a small portion of a provider’s total cases, and the full portion tells a different story.

The organizations that succeed don’t wait for a report card – they continuously measure outcomes giving clinical leaders confidence in their data and the ability to proactively communicate their performance before others define it for them.

A man in blue scrubs holding a tablet looks out a hospital window. He stands in a hallway with other people in the background, reflecting on patient reported outcomes (PROMs). A sign reading OUTCOMES is visible above, emphasizing the importance of measuring healthcare results.

How Strategic Organizations Put PROs to Work

Engage and align physicians

Give providers the meaningful, patient-direct feedback they need to evaluate their own outcomes, benchmark against peers, and drive continuous improvement.

Identify improvement opportunities

Uncover the outcome trends that traditional metrics miss. Capture the complete patient experience to improve care pathways and intervene earlier

Demonstrate value

Show patients and partners that your treatments work. Provide objective proof of improvement to pain, function, and quality of life to strengthen referrals and differentiate your organization.

Protect reimbursement

Secure your payment rates by meeting value-based care requirements. Use real-world evidence to evaluate programs and strengthen payer negotiations.

A doctor in a white coat works at a desk with medical charts on a computer screen, carefully reviewing patient-reported outcome measures (PROMs) to enhance healthcare decisions. In the foreground, there is a large hourglass with sand flowing, symbolizing the passage of time.

Questions That Separate Success from Risk:

Are you aligned with payer PROM requirements?

Are clinicians using the data on an individual patient basis?

Is the organization reviewing the aggregate data on a scheduled cadence?

Is the organization strategically using the data outside of just meeting payer requirements?

Are you asking the patients the right questions, at the right intervals, to evaluate individual patient outcomes and generate reliable aggregate data for quality improvement, benchmarking, and to support strategic decisions?

Ready to Take a More Strategic Approach to PROs?

Let’s evaluate your current program and identify opportunities to strengthen outcomes, reporting, and long-term performance.

Schedule a Strategy Session