All-Cause Admissions and Readmissions

This measure is important though does not seem timely or up to date and or should have an accompanying joint replacement ambulatory  measure. Also DQMs and EQMs are a CMS priority as well as meaningful measures. The state of full caregiving/ aftercare / full SNFs, LTAC (complex transitions) is such that patients too often languish in hospitals (not as mobile post surgery as they should be) where muscle strength decreases and this needs to be addressed (PT virtual? ) Follow up is important to readmissions and having telehealth options for many of the follow up visits is an important option.

Please see the attached PDF for Yale CORE's public comment for the THA/TKA Payment measure (CBE #3474). Thank you.

Having the ability to possibly expect or predict and document somewhere when it might be more likely that someone might be readmitted to a hospital setting after major joint surgery is important. Individuals with multiple issues that might interfere with a succesful 'easy' recovery after surgery might be noted in EHRs. Also today there are many who are doing ambulatory major joint surgeries where do not fit into this measure. Might be reconsidered for validity considering the landscape today

3474 Hospital-Level, Risk-Standardized Payment Associated with a 90-Day Episode of Care for Elective Primary Total Hip and/or Total Knee Arthroplasty (THA/TKA) 

The American Medication Association (AMA) agrees with the Standing Committee’s concerns around the validity of the measure as specified. We support the current recommendation to not maintain endorsement of this measure.