PRO-PM Reporting for TEAM:
How to Capture HOO Jr/KOOS Jr Without Burdening Staff
- SolvEdge
- July 09, 2026
- 6 mins read
CMS has folded patient-reported outcomes directly into hospital reimbursement under the Transforming Episode Accountability Model (TEAM). For Quality Directors and Ortho Service Line leaders, that turns HOOS Jr and KOOS Jr from a “nice to have” outcomes metric into a compliance requirement with real financial teeth collected by a workforce that already has no spare capacity.
This guide breaks down exactly what CMS requires, when it’s due, why manual collection fails to hit the threshold, and how to build a digital PRO-PM workflow that doesn’t add a single task to your surgical coordinators’ day.
Quick Answer
CMS requires TEAM-participating hospitals to collect HOOS Jr. (hip) and KOOS Jr. (knee) scores from patients before and after total hip and knee arthroplasty, matched for at least 50% of eligible patients, to support the THA/TKA PRO-PM measure. This measure feeds the TEAM Composite Quality Score (CQS), which can adjust reconciliation payments by up to 10–15%. Paper-based collection typically falls well short of the 50% threshold, which is why hospitals are moving to automated digital and SMS-based collection ahead of public reporting in FY 2028.
What Is the THA/TKA PRO-PM, and Why Is It Inside TEAM?
The Hospital-Level Total Hip and/or Total Knee Arthroplasty Patient-Reported Outcome-Based Performance Measure shortened to THA/TKA PRO-PM is a CMS quality measure that scores hospitals on whether patients experience a meaningful functional improvement after joint replacement.
It isn’t new to TEAM; mandatory PRO-PM reporting began for elective inpatient THA/TKA procedures in July 2024 under the Hospital Inpatient Quality Reporting (IQR) Program. What changed with TEAM is that this same measure now has a direct line to episode payment.
TEAM launched January 1, 2026, as CMS’s first mandatory bundled payment model, running through December 31, 2030, in selected Core-Based Statistical Areas (CBSAs). It covers five surgical categories, including lower extremity joint replacement (LEJR), and tracks 30-day episodes spanning both inpatient and hospital outpatient department procedures. For Performance Year 1 (2026), three measures roll into the TEAM Composite Quality Score (CQS): the Hospital-Wide Readmission measure, the CMS PSI-90 patient safety composite, and the THA/TKA PRO-PM.
One nuance worth flagging for your compliance file: In PY1, CMS calculates the PRO-PM’s contribution to the CQS using only the claims-based portion of the measure. That doesn’t reduce your obligation to collect the actual PROM survey data the underlying IQR reporting requirement (matched pre/post HOOS Jr/KOOS Jr. for 50% of eligible patients) still applies and still feeds public reporting starting FY 2028. It simply means the operational discipline you build now determines your star rating and your TEAM score simultaneously.
The financial stakes: the CQS can move a hospital’s reconciliation amount by roughly 10 to 15 percentage points in either direction. On a multimillion-dollar annual episode volume, that swing is not a rounding error it’s the difference between a bonus and a repayment obligation.
The PRO-PM Data Collection Requirements, Explained
CMS’s methodology is specific, and small deviations can invalidate a matched pair. Here’s what has to happen for every eligible patient counted toward the 50% threshold:
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Preoperative survey — HOOS Jr. (hip) or KOOS Jr. (knee) collected within 90 days before the procedure, plus supporting risk-variable questions (comorbidities, prior injections, general health status, and a health literacy screener).
Postoperative survey the same instrument the patient completed preoperatively, collected in a defined post-op window that lands roughly 300–425 days after the procedure (about 10–14 months out).
Matched pairs pre- and post-op responses must be linked to the same patient and the same procedure. An unmatched pair doesn’t count toward the 50% threshold.
Substantial Clinical Benefit (SCB) threshold CMS scores each matched pair as a binary success/fail based on point improvement: 22+ points on HOOS Jr. for hip patients, 20+ points on KOOS Jr. for knee patients. Industry benchmarks put the average SCB achievement rate in the 60% range, which is the bar your outcomes get measured against.
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50% minimum reporting rate this applies regardless of hospital volume. A five-case hospital and a 5,000-case hospital face the same percentage requirement, which disproportionately burdens lower-volume and rural-adjacent programs.
TEAM PRO-PM Reporting Cycle
| Reporting Cycle | Pre-Op Collection Window | Post-Op Collection Window | Submission Deadline |
|---|---|---|---|
| CY 2025 procedures | Oct 3, 2024 – Dec 31, 2025 | Oct 28, 2025 – Mar 1, 2027 | May 15, 2027 |
| CY 2026 procedures | Oct 3, 2025 – Dec 31, 2026 | Oct 28, 2026 – Feb 29, 2028 | May 15, 2028 |
| CY 2027 procedures | Oct 3, 2026 – Dec 31, 2027 | Oct 28, 2027 – Feb 28, 2029 | May 15, 2029 |
(Windows compress procedure dates against submission deadlines that sit more than a year out)
(Windows compress procedure dates against submission deadlines that sit more than a year out which is exactly why a manual, retroactive chart-chase strategy collapses under its own weight.)
Looking ahead, Performance Year 3 (2028) adds an Information Transfer PRO-PM around discharge instruction clarity, and CMS has signaled that PROM-based quality reporting is expanding, not shrinking. Spinal fusion and CABG-specific PROMs are already under discussion for future TEAM cycles.
Why Manual PROM Collection Doesn’t Hit 50%
Paper-based PROM collection structurally cannot reach the CMS threshold at scale. Programs relying on clipboard intake at pre-op visits and mailed follow-up surveys routinely see completion rates in the single digits to low double digits nowhere close to 50%, and nowhere close to the matched-pair requirement that needs both ends of the survey completed by the same patient a year apart.
The staff burden compounds the problem. Every paper PROM requires someone to hand it out, someone to collect it, someone to manually enter scores into a registry or EHR flowsheet, and someone to chase the 10-14 month post-op survey with no automated trigger. None of this work is separately reimbursed. It lands on surgical coordinators and nurse navigators who are already stretched across intake, prior authorization, and care coordination for the 30-day TEAM episode itself.
The hospitals hitting the 50% threshold comfortably share a common pattern: they’ve removed the human being from the trigger point. The system not a staff member’s memory decides when a patient is due for a survey and sends it.
How to Capture HOOS Jr/KOOS Jr Digitally Without Adding Staff Work
Automate the trigger, not just the survey,
The highest-leverage fix isn’t switching from paper to a digital form it’s removing the human trigger entirely. When a scheduling or EHR event fires (surgery scheduled, patient discharged), the system should automatically queue the correct instrument (HOOS Jr. vs. KOOS Jr.) and the correct timing window, with zero coordinator action required.Use SMS/patient-portal delivery, not paper or portal-only
Text-based delivery consistently outperforms paper and out-performs portal-only strategies, because it meets patients where they already are and requires no login. For patients who screen positive on health literacy or connectivity barriers, an automated phone-call fallback keeps the matched pair intact instead of silently dropping the patient from your denominator.Auto-match pre- and post-op pairs
Manual chart abstraction is where matched pairs get lost. A system that ties every postoperative response back to the original preoperative survey by patient and procedure ID automatically is what actually protects your 50% number, since CMS only credits matched pairs, not raw response counts.Build the risk-variable capture into the same workflow
The preoperative risk variables (comorbidity flags, prior injections, general health, SILS-2 literacy screen) are frequently the fields that get skipped when staff are rushing through intake. Bundling them into the same digital instrument as the HOOS Jr./KOOS Jr. survey rather than a separate form keeps the whole submission complete on the first pass.Give quality and service-line leaders a live compliance dashboard Waiting until the May submission deadline to discover you’re under 50% is the single most expensive mistake a program can make, given the 10-14 month lag between procedure and post-op window. A real-time dashboard showing current matched-pair completion rate by surgeon and by month lets you course-correct mid-cycle instead of after the fact.
Route escalations, don’t generate more inbox noise
Automated collection only reduces burden if the exceptions are routed intelligently a patient reporting a concerning pain spike or a survey that goes three reminders without response should escalate to the right person (nurse coordinator vs. surgeon) rather than becoming another item in a shared inbox nobody owns.
PRO-PM / TEAM Compliance Checklist
Use this as a working audit against your current program
- Confirmed whether your hospital’s CBSA is included in mandatory TEAM participation
- Identified which surgeons/service lines generate eligible THA/TKA volume
- Selected and validated the CMS-designated instrument (HOOS Jr. for hip, KOOS Jr. for knee) — no substitutions
- Moved primary collection channel to electronic/SMS delivery rather than paper
- Automated the pre-op survey trigger tied to surgical scheduling (90-day window)
- Automated the post-op survey trigger tied to procedure date (300-425 day window)
- Built automatic pre/post matched-pair linkage by patient and procedure ID
- Included all required risk-variable and health-literacy screening questions in the same intake
- Established a live, role-visible dashboard tracking completion rate against the 50% threshold
- Defined escalation protocols for concerning patient-reported responses
- Assigned executive ownership (Quality Director or Ortho Service Line Director) for monthly CQS-readiness review
- Confirmed submission workflow and deadline alignment for your applicable performance year
Frequently Asked Questions
PRO-PM (Patient-Reported Outcome-Based Performance Measure) is a CMS quality measure that scores hospitals on whether joint replacement patients report a substantial clinical benefit after surgery, using matched pre- and postoperative HOOS Jr./KOOS Jr. surveys. Under TEAM, it is one of the measures used to calculate the Composite Quality Score that adjusts episode reconciliation payments.
No. CMS requires a minimum 50% matched-pair reporting rate across eligible THA/TKA patients, regardless of hospital procedure volume. However, incomplete or unmatched data below that threshold results in a neutral or reduced quality score, so most programs aim well above the minimum for a safety margin.
SCB is the CMS-defined threshold for a meaningful outcome improvement: a 22-point or greater increase on HOOS Jr. for hip patients, or a 20-point or greater increase on KOOS Jr. for knee patients, measured between the matched pre- and postoperative surveys.
CMS has stated public reporting of the THA/TKA PRO-PM will begin following the mandatory reporting period, starting with fiscal year 2028, based on procedure data collected from July 2024 onward.
The PRO-PM score contributes to the hospital’s Composite Quality Score (CQS), which can adjust net TEAM reconciliation payments by roughly 10–15% in either direction, depending on participation track.
Paper collection depends on staff to hand out, collect, and manually enter forms at two separate points in time up to 14 months apart. In practice, this workflow produces completion rates far below the 50% matched-pair requirement, largely due to lost postoperative follow-up.
No. The underlying THA/TKA PRO-PM reporting requirement applies to IPPS-paid acute care hospitals generally under the IQR program. TEAM adds a direct financial consequence for hospitals in mandatory CBSAs by tying the measure to episode reconciliation.
Turn PRO-PM From a Compliance Risk Into a Quality Story
Quality and Ortho Service Line leaders don’t need another spreadsheet to chase they need a workflow that collects HOOS Jr./KOOS Jr. automatically, matches pairs without manual chart work, and gives them a real-time read on where their Composite Quality Score stands before CMS calculates it for them.
SolvEdge’s RecoveryCOACH platform is purpose-built for exactly this: automated pre- and post-op PROM delivery, matched-pair tracking, risk-variable capture, and escalation routing without adding a single task to your surgical coordinators’ plates.
See how RecoveryCOACH captures CMS-compliant HOOS Jr./KOOS Jr. data for your TEAM episodes, end to end.