Home Health & Hospice Week

Prepare for ‘huge changes’ to OASIS.

Payment rates aren’t the only things Medicare will be cutting in 2019.

The Centers for Medicare & Medicaid Services “reviewed the OASIS-C2 item set to identify candidate items for removal,” CMS says in its HH PPS Proposed Rule fact sheet. “Based on this analysis, CMS is proposing to remove or modify 35 current OASIS items, beginning on January 1, 2019.”

CMS wants to cut the items/elements because “these OASIS items, or data elements within OASIS items, are not used in the calculation of quality measures already adopted in the HH QRP, nor are they used for previously established purposes unrelated to the HH QRP, including payment, survey, the HH VBP Model or care planning,” the agency says in the rule.

CMS also is proposing to adopt for the CY 2020 payment determination three measures to meet the requirements of the IMPACTAct, the agency notes. The three measures are assessment-based and are calculated using OASIS data. The proposed measures are:

• Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury;
• Application of Percent of Residents Experiencing One or More Falls with Major Injury (NQF #0674); and
• Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (NQF #2631).

The OASIS and quality provisions of the rule represent a “huge change to OASIS,” says reimbursement consultant Melinda Gaboury with Healthcare Provider Solutions in Nashville, Tennessee.

Note: See a list of the proposed OASIS changes in documents in the “Downloads” section at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIQualityMeasures.html.