Keet Outcomes supports quality measures which are relevant for clinicians that provide care to patients with musculoskeletal conditions. Patients being treated for other injuries or classifications will not be included in MIPS reporting and will not be required to complete a Patient Reported Outcome (PRO) form. The Quality Measures reported to Medicare by Keet Outcomes are based on the number of patients with Failure to Progress (FTP) as calculated from the relevant Patient Reported Outcomes forms for the following areas:
Proportion of patients failing to achieve a Minimal Clinically Important Difference (MCID) to indicate functional improvement
Proportion of patients failing to achieve a minimally Clinically Important Difference (MCID) in improvement in pain score
For each case or region of injury at least one Patient-Reported Outcome -or PRO form should be completed. Each completed PRO will equal 2 measures; Functional and NPRS pain. The practitioner will collect measures from NDI, KOS, MDQ, LEFS, Q-DASH and DHI cases throughout the reporting year. Therefore at the end of the reporting year, Keet will submit all 10 of those measures. (2 for each PRO form collected) Your practitioner must submit data for at least 6 of these measures; meaning at least 3 of these regions of injury (NDI, KOS, MDQ, LEFS, Q-DASH) per reporting year. For the Dizziness Handicap Inventory (DHI) only one PRO is required for submission and does not include a separate NPRS pain PRO.
Please review the Quality Measures and how they score in this section:
CMS-Approved Patient-Reported Outcome Quality Measures supported by Keet Outcomes
Knee Rehabilitation of patients with knee injury Functional Improvement measured via the validated Knee Outcome Survey (KOS) score. KOS is a patient self-report survey consisting of 14 questions that ask the patient about their level of difficulty when completing a set of tasks. Six focus on the patient's general daily activities while another 8 focus on their ability to perform specific tasks. These are each scored on a scale of 0 - 5, with 5 indicating “Activity is not difficult” and 0 indicating “Unable to perform”. The total score is summed, divided by 70, and multiplied by 100 to provide a % of disability.
Arm, Shoulder, and Hand Rehabilitation of patients with injury Functional Improvement measured via the validated Quick Disability of Arm Shoulder and Hand (Q-DASH) score. Quick DASH is a patient self-reported survey used to measure physical function in people with one or multiple upper extremity disorders. The Quick DASH consists of 11 questions regarding a patient's current functional level; with each possible answer having a score 0 - 5. The total of the 11 questions is summed and averaged, with the newly found value being out of 5 (eg 3/5). The new score is then multiplied by 25 (3.25 * 25) to provide a score that reflects a total out of 100 (eg. 81/100). The higher the score, the higher the level of disability.
Neck Pain Rehabilitation of patients with injury Functional Improvement measured via the validated Neck Disability Index (NDI). NDI tests a patient's self-perceived percentage of disability in their neck. The test is broken down into 10 separate sections, with 6 possible answers for each. These answers are each scored from 0 - 5, with 5 indicating Worst Imaginable Pain and 0 indicating No Pain. Once completed the total sum of the scores is compared to the maximum of 50. The obtained score can be multiplied by 2 to produce a percentage of disability. The higher the score, the greater the level of disability.
Rehabilitation of Patients with Hip, Leg or Ankle Injuries Functional Improvement measured via the validated Lower Extremity Function Scale (LEFS). LEFS is a patient self-reported survey consisting of 20 questions about a person’s ability to perform everyday tasks, focusing on their lower extremities. Each question is scored 0 - 5, with 0 indicating extreme difficulty or inability to perform activity and 5 indicating no difficulty. The total is summed, divided by 80 (total max), and then multiplied by 100 to provide the therapist with a % of maximum function.
Functional improvement in low back rehabilitation of patients with low back pain measured via the validated Modified Low Back Pain Disability Questionnaire (MDQ). The Modified Low Back Pain Disability Questionnaire is a patient self-reported survey used to help rate a patient's level of low back disability and functionality. The questionnaire consists of 10 questions that ask for a patient's perceived level of limitation. Each of these questions is scored on a scale of 0 - 5, with 0 indicating pain prevents the specific function from occurring and 5 indicating that there is no limitation in the function. The scores are then summed, divided by 50, and multiplied by 100. This sum provides the clinician with a total % of functional ability.
NPRS by PRO
Plus, the Pain improvement measured by the Numeric Pain Rating Scale (NPRS) is amended on each of the above patient-reported outcome measures. NPRS is a patient self-reported survey, in which patients rate their pain on a numerical scale of 0 - 10. The scale value can be used over time to rate a patient's progress based on how much pain they are identifying.
Functional improvement in dizziness of patients with dizziness via the Dizziness Handicap Inventory. The DHI self-assessment inventory is designed to evaluate the self-perceived handicap effects caused by dizziness. The questionnaire consists of 25 questions that asks for a patient's perceived level of limitation. Each of these questions are scored on a scale of 0-4, with 0 indicating no, 2 indicating sometimes, and 4 indicating yes. The scores are then summed with a maximum score of 100 and lowest score of 0. The higher the score, the greater perceived handicap due to dizziness.
PRO Measure IROMS Codes
- KOS - IROMS 11
- KOS NPRS - IROMS 12
- LEFS- IROMS 13
- LEFS NPRS- IROMS 14
- NDI- IROMS 15
- NDI NPRS- IROMS 16
- MDQ- IROMS 17
- MDQ NPRS- IROMS 18
- Q-DASH- IROMS 19
- Q-DASH NPRS- IROMS 20
- DHI - HM07