Health Catalyst, Inc · NASDAQ:HCAT
Health Catalyst — Technical Presentation (September 2024)
44 slides from Health Catalyst's technical presentation, September 2024
Slide 1: Automated Patient Reported Outcomes (PROs) for Hip & Knee Replacement
Automated Patient Reported Outcomes (PROs) for Hip & Knee Replacement Don’t Limp Into John Janas, MD Mandatory Reporting © Health Catalyst. Confidential and Proprietary.
Slide 2: Agenda
• Overview of Voluntary and Mandatory Patient- Reported Outcome (PRO) Collection for Total Hip and Knee Arthroplasty (THA/TKA) Agenda • • Requirements Potential Impact • Automated Patient Reported Outcomes (PROs) for Hip & Knee Replacement • Clinical Workflows • PRO components • Improving Patient En
Slide 3: Voluntary and Mandatory Patient-Reported Outcome Collection for Total Hip and Knee Arthroplasty
Voluntary and Mandatory Patient-Reported Outcome Collection for Total Hip and Knee Arthroplasty • FY2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Pr ospective Payment System (LTCH PPS) Final Rule • Hospital-Level, Risk Standardized Patient-Reported Outcomes Performance
Slide 4: Comprehensive Care for Joint Reconstruction (CJR) Model
Comprehensive Care for Joint Reconstruction (CJR) Model • Initially a Voluntary PRO data collection program in the Comprehensive Care for Joint Reconstruction (CJR) model—to address disparities in outcomes and clinical practice across US hospitals • Clinical improvement measured based on the differe
Slide 5: Poll Question #1
Poll Question #1 • Are you (your hospital) currently participating in the Voluntary Patient- Reported Outcome (PRO) Collection for Total Hip and Knee Arthroplasty (THA/TKA)? • Yes • No © Health Catalyst. Confidential and Proprietary.
Slide 6: Alphabet Soup
Alphabet Soup • PRO = Patient Reported Outcome • PROM = Patient Reported Outcome Measure • Standardized tools • Surveys, scales, or single-item measures • PRO-PM = Patient Reported Outcome-based Performance Measure • Performance measure based on patient-reported outcome measure (PROM) data aggregate
Slide 7: KOOS JR: 7 Items Scoring
SCORING: Convert Raw KOOS JR: 7 Items Score (0-28) to Interval Score (0-100)* *Meet or exceed a threshold of 20 points on Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) © Health Catalyst. Confidential and Proprietary.
Slide 8: HOOS JR: 6 Items Scoring
HOOS JR: 6 Items SCORING: Convert Raw Score (0-24) to Interval Score (0-100)* *Meet or exceed a threshold of 22 points on Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) © Health Catalyst. Confidential and Proprietary.
Slide 9: What Data Needs to Be Reported and How to Submit
What Data Needs to Be Reported and How to Submit • HCQIS Access Roles and Profile (HARP) account access to the Hospital Quality Reporting (HQR) website • “What Data Should I Collect?” from CMS QualityNet THA/TKA PRO-P M Resources. © Health Catalyst. Confidential and Proprietary.
Slide 10: What Data Needs to Be Reported
What Data Needs to Be Reported © Health Catalyst. Confidential and Proprietary.
Slide 11: CJR Model Quality Measures
CJR Model Quality Measures Hospital Inpatient Quality Reporting (HIQR) program already collect: • THA/TKA Complications Measure (NQF #1550) • Risk-standardized complication rate (RSCR) in the 90- day period following THA and/or TKA • Hospital Consumer Assessment of Healthcare Providers and Systems(H
Slide 12: 2024 Performance Measure CMS56v12: Functional Status Assessment for Total Hip Replacement
2024 Performance Measure CMS56v12: Functional Status Assessment for Total Hip Replacement • Percentage 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 -
Slide 13: Denominator Exclusions
Denominator Exclusions • 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 trau
Slide 14: 2024 Performance Measure CMS66v10: Functional Status Assessment for Total Knee Replacement
2024 Performance Measure CMS66v10: Functional Status Assessment for Total Knee Replacement • Percentage of patients 18 years of age and older who received an elective primary total knee arthroplasty (TKA) and completed a functional status assessment within 90 days prior to the surgery and in the 270
Slide 15: Denominator Exclusions
Denominator Exclusions • Exclude patients with two or more fractures indicating trauma at the time of the total knee arthroplasty or patients with severe cognitive impairment that starts before or in any part of the measurement period. • Exclude patients who are in hospice care for any part of the m
Slide 16: Poll Question #2
POLL QUESTION #2 • Are you (your Organization) already collecting Patient Reported Outcomes pre and post-operative for the: • Veterans RAND 12-item health survey [VR-12] or [PROMIS]-10 Global Health • Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr • Knee Injury and Osteoarthritis Ou
Slide 17: Patient Reported Outcomes (PRO) and Risk Variable Data
PATIENT REPORTED OUTCOMES (PRO) AND RISK VARIABLE DATA • Veterans RAND 12 Item Health Survey (VR-12) or • PROMIS-10 Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 generic PRO survey • Knee Injury and Osteoarthritis Outcome Score [KOOS], KOOS Jr.) in the 90 days prior to
Slide 18: Voluntary to Mandatory
Voluntary to Mandatory Surgery Performed Pre-op Submit Pre- Post-op PROM PROM op => Submit 2022-16472.pdf (federalregister.gov) © Health Catalyst. Confidential and Proprietary.
Slide 19: Impact of Mandatory Reporting
Impact of Mandatory Reporting 4/2/2024: Requirement to start collecting Patient Reported Outcome Measures (PROM) 7/1/2024: Mandatory Reporting Begins Minimum Required: 50% of their eligible Patients Penalty for not meeting above requirement: 25% reduction of the applicable percentage increase on the
Slide 20: Impact of Mandatory Reporting
IMPACT of MANDATORY REPORTING • No penalties for hospitals that choose to not participate in voluntary reporting • Voluntary Reporting Ends in 2023 becomes MANDATORY Reporting July 1, 2024 (START CAPTURING PRE-OP SURVEYS April 2, 2024!) • Hospitals that do not meet the minimum requirement of submi
Slide 21: Potential Financial Impact
Potential Financial Impact • Operating Margins for Hip and Knee Replacement are narrow! • Adding in a 25% reduction in the APU could mean the difference between make or break!!! • The American Association of Hip and Knee Surgeons (AAHKS) reports that the price of hip replacement surgery in the U.S.
Slide 22: Margins Increasing Demand
Mandatory Reporting – Minimal Margins INCREASING Main Issue: Demand •Hospitals do NOT have time to set up a customized solution Average Ortho Practice: •~500 Hip Replacements/year •3-5% Readmission rate •~$15k/Readmission Demand (by 2030): •Primary Total Hip Arthroplasties is projected to gr
Slide 23: Just the Beginning!
Just the Beginning! • Voluntary becomes Mandatory • Incentive becomes Reduction (FY2028 25% reduction in APU) • 25% becomes 50% becomes 75% becomes 100% • Hospital-based (IP) for 2024 => OP in © Health Catalyst. Confidential and Proprietary.
Slide 24: Automated PROs for Hip & Knee Replacement: Clinical Workflow
Automated Patient Reported Outcomes (PROs) for Hip & Knee Replacement: Clinical Workflow • Clinical Pathway Automatically Launches at time Surgery is Scheduled • Patient receives PRO questionnaires using secure SMS text within 90 days of surgery date • Automated reminders and patient outreach to ass
Slide 25: Keys to Success is Automation & Design
KEYS to SUCCESS is AUTOMATION & DESIGN • Does not require Provider or Staff involvement to start, complete, or score • Patient can complete at their convenience • Friendly reminders until completed • Easy to Use interface and standardized PROs • Automatic Scoring & Capture of Structured Data for Rep
Slide 26: Currently Available Pathways
CURRENTLY AVAILABLE PATHWAYS • Total Hip Arthroplasty/Total Knee Arthroplasty Patient-Reported Outcome Based Performance Measure (THA/TKA PRO-PM) • Pre-Surgery & Post-Surgery ▪ HOOS Jr (THA) or KOOS Jr (TKA) ▪ Mental Health Subscale items from PROMIS Global or complete PROMIS-10 Global (optional) ▪
Slide 27: Benefits: Patients & Clients
BENEFITS: Patients & Clients © Health Catalyst. Confidential and Proprietary.
Slide 28: Suggested Key Quality Measures
Suggested Key Quality • Measures % adoption • NOT Part of the PRO- PM Requirements! • % provider and patient engagement • Used for Internal • Patient satisfaction Monitoring of Process • % increase in form response rate from baseline • % of completion of PRO forms • % decrease in staff hours dedicat
Slide 29: Total Hip Arthroplasty Patient-Reported Outcome-Based Performance Measure
• When THA Surgery Total Hip Arthroplasty Scheduled, Patient-Reported Patient Outcome-Based Automatically Performance Measure Receives (THA/TKA PRO-PM) Secure SMS Text Message with Link to THA PRO-PM Pre-surgery Pathway in Secure Web Browser • Patient clicks © Health Catalyst. Confidential and Propr
Slide 30: Total Knee Arthroplasty Patient-Reported Outcome-Based Performance Measure
• Patient completes HOOS JR and Total Knee Arthroplasty additional Patient-Reported required Outcome-Based components in Performance Measure form and then (THA/TKA PRO-PM) “Submits” • HOOS JR & PROMIS-10 automatically scored • Results automatically sent as structured data to EHR © Health Catalyst. C
Slide 31: Total Knee Arthroplasty Patient-Reported Outcome-Based Performance Measure
• Patient receives Total Knee Arthroplasty reminders to Patient-Reported complete the Outcome-Based questionnaire Performance Measure (THA/TKA PRO-PM) • Every 3 days X 3 • After 3 reminders, if not completed, can automatically © Health Catalyst. Confidential and Proprietary. alert Team
Slide 32: Benefits: Patients & Clients
BENEFITS: Patients & Clients © Health Catalyst. Confidential and Proprietary.
Slide 33: Questions & Answers
QUESTIONS & ANSWERS © Health Catalyst. Confidential and Proprietary.
Slide 34: Question 1: Patient Response Rate
QUESTION 1 • Q: What is your typical patient response rate for completion of the PRO Forms? • A: ~90% Completion Rate (~100% Pre-op) • 80-85% directly by patient • Additional 5-10% completed by family member/care taker © Health Catalyst. Confidential and Proprietary.
Slide 35: Question 2: Other PRO-PM CQMs
Question 2 • Q: What other PRO-PM CQMs are there for 2023/2024? • A: There are numerous PRO-PM CQMs for 2023/2024 and more being proposed for future years (see next slide) © Health Catalyst. Confidential and Proprietary.
Slide 36: PRO-PM CQMs by Program
PRO-PM CQMs by PROGRAM o Quality Payment Program (QPP): § Functional Status Assessment for Total Knee Replacement (CQM #470) § Functional Status Assessment for Total Hip Replacement (CQM & eCQM (#376/CMS56v11)) § Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasi
Slide 37: PRO-PM CQMs by Program
PRO-PM CQMs by PROGRAM o Quality Payment Program (QPP): § Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery (CQM #303) § Varicose Vein Treatment with Saphenous Ablation: Outcome Survey (CQM #420) § Back Pain After Lumbar Surgery (CQM #459) § Leg Pain After
Slide 38: PRO-PM CQMs by Program
PRO-PM CQMs by PROGRAM o Quality Payment Program (QPP) PROPOSED (Future Years): § Gains in Patient Activation Measure (PAM®) Scores at 12 Months • Patient Activation Measure® (PAM®) § Ambulatory Palliative Care Patients’ Experience of Feeling Heard and Understood • Feeling Heard and Understood (HU)
Slide 39: PRO-PM CQMs by Program
PRO-PM CQMs by PROGRAM o Hospital Outpatient Quality Reporting Program (HOQRP): § OP-31: Improvement in Patient’s Visual Function Within 90 Days Following Cataract Surgery § (proposed) Risk-Standardized Patient- Reported Outcomes Following Elective Primary Total Hip and/or Total Knee Arthroplasty ·
Slide 40: PRO-PM CQMs by Program
PRO-PM CQMs by PROGRAM o ASC Quality Reporting Program (ASC QRP): § ASC-11: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery § (proposed) Risk-Standardized Patient- Reported Outcomes Following Elective Primary Total Hip and/or Total Knee Arthroplasty · Proposed in C
Slide 41: Question 3: Threshold and Interval Score
QUESTION 3 • Q: You said: Clinical improvement measured based on the difference in patient score on joint-specific PRO instruments between preop PRO assessment and postop PRO assessment • Meet or exceed a threshold of 22 points on Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacemen
Slide 42: KOOS JR: Raw Score to Interval Score
SCORING: Convert KOOS JR: 7 Items Raw Score (0-28) to Interval Score (0- 100)* *Meet or exceed a threshold of 20 points on Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) © Health Catalyst. Confidential and Proprietary.
Slide 43: HOOS JR: Raw Score to Interval Score
SCORING: Convert HOOS JR: 6 Items Raw Score (0-24) to Interval Score (0- 100)* *Meet or exceed a threshold of 22 points on Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR) © Health Catalyst. Confidential and Proprietary.
Slide 44: Question 4: Outpatient Procedures
Question 4 • Q: Does the Mandatory Reporting apply to Outpatient Procedures (THA/TKA)? • A: For 2024, it only applies to INPATIENT Procedures! Expect it to apply to Outpatient Procedures in near future. © Health Catalyst. Confidential and Proprietary.
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