As regulations evolve and enforcement tightens, Compliance Officers face growing pressure to ensure their organizations meet today’s standards—and prepare for what’s next. One emerging strategy to stay ahead of compliance pitfalls? A system-wide patient-reported outcomes (PRO) program.
Though traditionally viewed as clinical tools, PROs are now a key component of a modern compliance strategy. In 2025, Compliance Officers who champion PROs won’t just mitigate risk—they’ll help their organizations lead with data-backed confidence
What Are PROs and Why Are They Valuable?
Patient-reported outcomes (PROs) are standardized, validated measures that capture a patient’s own assessment of their health, symptoms, and quality of life. These insights come directly from the patient—without clinician interpretation—and are essential for organizations focused on improving care quality, reducing risk, and succeeding under value-based care models.
For quality and compliance teams alike, PROs support efforts to enhance patient engagement, ensure regulatory alignment, reduce unnecessary variation in care, and improve clinical performance.
PROs and Value-Based Care
As healthcare continues its shift from fee-for-service to value-based models, PROs are becoming central to how performance is measured—and reimbursed. Several federal programs already incorporate PROs, signaling a clear regulatory direction:
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The CMS THA/TKA PRO-PM is the first mandated patient-reported outcome performance measure, requiring hospitals to collect and report PROs for total hip and total knee arthroplasty patients. It sets a precedent for future CMS initiatives.
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The CMS Quality Payment Program (QPP) allows clinicians to earn points under the Merit-Based Incentive Payment System (MIPS) for reporting PRO-based quality measures.
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Under the Inpatient Quality Reporting (IQR) program, hospitals can use PROs to fulfill quality metric requirements and strengthen performance scores.
These initiatives reflect a growing regulatory emphasis on the patient voice. For Compliance Officers, that means PROs are no longer optional—they’re foundational to staying aligned with federal expectations.
How to Effectively Implement a PRO Program
To meet regulatory expectations and ensure consistent data collection, a PRO program should be system-wide and must be integrated with your EHR infrastructure. Key considerations when evaluations a PRO program include:
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Survey collection strategies: Maximizes survey compliance to create robust patient data sets.
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Security & regulatory compliance: Must meet or exceed HIPAA and CMS requirements.
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Data analysis capabilities: Supports data analysis aimed at improving care quality.
The right implementation approach sets the foundation for consistent, compliant, and scalable PRO data collection.
How a Comprehensive PRO Program Can Ensure Compliance
When implemented effectively, a PRO program becomes a compliance asset—not a liability.
PROs turn abstract mandates into measurable performance indicators. They provide real-time visibility into patient safety and care quality, reduce reporting errors through EHR integration, and ensure consistent documentation across departments. Most importantly, they help organizations identify care gaps before they become regulatory issues—supporting proactive risk mitigation and audit readiness.
PRO data can also reveal variations in outcomes that might otherwise go unnoticed. One nationally recognized academic health system used PatientIQ for short-term socioeconomic research, uncovering actionable disparities that led to enhanced patient care. Read the case study.
By equipping teams with standardized, patient-centered data, PROs help bridge compliance and clinical operations—strengthening system-wide accountability.
Why Now
With the CMS THA/TKA PRO-PM already in effect—and more patient-centered performance measures on the horizon—health systems that delay PRO adoption risk falling behind. Regulators are making it clear: measurable outcomes are the future of compliance.
Now is the time to act. PROs aren’t just a clinical initiative—they’re a strategic imperative. Ready to stay ahead of regulatory change? Contact us today for a demo and see how PatientIQ can help your compliance program set the pace in 2025.
