Orthopaedic Quality Reporting: A Comprehensive Review of the Current Landscape and a Roadmap for Progress.

Abstract

Passage of the Patient Protection and Affordable Care Act in 2010 mandated sweeping changes to the United States health-care system1. The Patient Protection and Affordable Care Act has vastly expanded the government’s involvement in tracking and reporting quality measures for physicians and hospitals, creating a dizzying array of stakeholders in this complex policy arena (Fig. 1). Quality measures are now increasingly tied to reimbursement, potentially redefining payment models for physicians and hospitals across the country. Medicare alone will base 9% of hospital payments on performance by 20172. Fig. 1 Roadmap and relationships of major quality stakeholders. ACS = American College of Surgeons, AHRQ = Agency for Healthcare Research and Quality, AAOS = American Academy of Orthopaedic Surgeons, CDC = Centers for Disease Control and Prevention, CMS = Centers for Medicare & Medicaid Services, HACs = hospital-acquired conditions, HHS = U.S. Dept. of Health & Human Services, MAP = Measure Applications Partnership, NIH = National Institutes of Health, NPP = National Priorities Partnership, NSQIP = National Surgical Quality Improvement Project, NQF = National Quality Forum, PQRS = Physician Quality Reporting System, PROMIS = Patient-Reported Outcomes Measurement Information System, and SCIP = Surgical Care Improvement Project. Quality measurement has …