Home Health & Hospice Week

Check new revisions in final OASIS version.

Home health agencies trying to decide how to prioritize their duties in the coming weeks and months should be sure OASIS is at the front of the line — especially with Value-Based Purchasing kicking off Jan. 1.

“Many OASIS-E items are part of the calculations for Home Health Value-Based Purchasing,” highlights Beth Noyce with Noyce Consulting. “Clinicians’ responses can have great impact on an agency’s future bottom line, either for better or for worse. Education gives the agency its best shot at positive results,” Noyce emphasizes.

“Every item in OASIS-E is there for a reason,” Noyce stresses. “More times than not, it’s to feed into the equation for HHVBP to determine which agencies get their pay boosted and which agencies receive penalties that decrease their payment in future years,” she cautions.

With OASIS-E implementation nearly upon agencies, check out this advice on how to make the most of the last few weeks:

• Look to the OASIS bible. “Agencies should ensure their clinicians clearly understand the item-specific guidance in the OASIS-E Guidance Manual so that they capture the most accurate patient-status data possible at each time point,” Noyce recommends.
• Spend time — and money — on education. “Some subtleties of the new OASIS-E items may escape those who don’t study the guidance closely,” Noyce cautions. “I recommend providing education to all clinicians who may complete any OASIS-E comprehensive assessment,” she says.

“Some agencies may shy away from OASIS-E training because of its cost,” Noyce acknowledges. “I would tell them the education is well worth the investment.” Shop around for a good deal, considering factors such as speaker expertise and travel costs, she suggests.

• Tackle the big changes first. “I’d begin with the OASIS-E items that were not part of OASIS-D1 so each clinician will at least have some familiarity with those new items before they’re expected to administer them during comprehensive assessments,” Noyce offers.

Remember, OASIS-E is about 75 percent current OASIS items and 25 percent new items, notes Cindy Krafft with K&K Health Care Solutions. In addition to the Brief Interview for Mental Status (BIMS), the Confusion Assessment Method (CAM), and the Patient Health Questionnaire–2 to 9 (PHQ–2 to 9) are Social Determinants of Health (SDoHs), among other changes.

• Avoid education overload. “If the agency doesn’t have time to enroll everyone in an intensive course, I recommend choosing one that allows clinicians to learn the OASIS-E items a piece at a time, over a few weeks,” Noyce says. “Bonus points if the course provides recordings of the education to review later for new staff or to brush up on things based on problems found during QAPI studies over the months ahead,” she adds.
• Check for changes. If you’ve been educating on OASIS-E for a while, now’s the time to make sure the final version syncs up with your previous teachings.

“I would recommend people use the PDF doc from CMS that highlights the specific differences between the proposed and final manual to tweak any education that have done and to confirm the most current information will be in the EMR,” Krafft tells AAPC. That document is at www.cms.gov/files/document/oasis-e-changes-draft-final-instrument-and-manual12012022.pdf.

• Monitor to boost accuracy. Don’t consider your job over when initial OASIS-E training is complete.

“OASIS data accuracy tends to decrease over time as assessors get busy and their attention inevitably gets pulled many ways,” Noyce cautions. “Accurate data collection throughout the entire OASIS-E instrument is vital to an agency’s success over time — especially as we enter the era of nationwide Home Health Value-Based Purchasing,” she notes.

Watch out: “Responses to many seemingly benign OASIS-E items could spell the difference between rewards and penalties for an agency that ignores the importance of completing the OASIS-E correctly,” Noyce warns.