Home Health & Hospice Week

Watch out: VBP, holiday time frame will complicate implementation.

With about three months to go before the OASIS-E tool goes live, home health agencies need to maximize their training and other preparations for the heavily revised new patient assessment tool.

“OASIS-E is a significant update,” emphasizes Karen Tibbs with consulting firm McBee.

OASIS-E is about 75 percent current OASIS items and 25 percent new items, points out Cindy Krafft with Kornetti & Krafft Health Care Solutions.

And some of those new items are doozies with exacting requirements. “The BIMS, CAM and PHQ-2 to 9 are standardized assessments that require a specific process to administer,” Tibbs observes. “Performing this process according to instructions will require a longer learning curve due to the steps involved,” she expects.

Reminder: The Brief Interview for Mental Status (BIMS) is addressed in OASIS-E items C0100, C0200, C0300, C0400, C0500; the Confusion Assessment Method (CAM) is covered in C1310 A-D; and the Patient Health Questionnaire–2 to 9 (PHQ–2 to 9) is addressed in D0150 A-I and D0160.

“The BIMS requires that these questions must be performed exactly as directed,” highlights Angela Huff with FORVIS. “Clinicians are going to have to do that right in the OASIS tool at the point of care and not from memory,” she stresses.

Further complicating OASIS-E implementation is the Expanded Home Health Value-Based Purchasing payment model taking effect at the same time.

“OASIS-E will be the first OASIS version that will be used by every agency in the nation … when HHVBP expands Jan. 1, 2023,” notes Beth Noyce with Noyce Consulting. “For those agencies that haven’t been part of HHVBP before this, it may seem like a lot to swallow both OASIS-E and HHVBP all at once,” Noyce tells AAPC.

“The hardest part about the transition [to OASIS-E] is going to be the timing with the VBP expansion kicking off on the exact same date and time,” Huff predicts. “Agencies have to be fully ready on Jan. 1 with the new tool and not lose focus on not only the OASIS items that are part of VBP, but also the Claims and CAHPS elements,” she says.

An added complication is that both VBP and OASIS-E will hit right toward the end of the hectic holiday season, which is especially strained under current workforce shortages. “October is here and we are entering the holiday season which is full of distractions already without a new OASIS-E and VBP starting on Jan. 1,” Huff laments. “Time will fly by and your organization will need to be ready to hit the ground running on day 1,” she advises.

Enjoy These Perks Of OASIS-E

While implementing OASIS-E will take a lot of work, it won’t be without its advantages. “OASIS-E has many virtues,” Noyce lauds.

“I personally like the way the format is laid out,” offers J’non Griffin with SimiTree Healthcare Consulting. “It makes sense,” Griffin tells AAPC.

“I really like that the pain question has specific time frames,” Griffin adds. That’s “opposed to the recent relevant past,” she notes.

OASIS-E is “so much better,” judges Arlynn Hansell, also with SimiTree. “The pain items are more focused, easier to understand,” Hansell says.

That “focus on the patient’s pain … could help clinicians better identify how to help the patient,” Noyce praises.

“The OASIS is more patient-centered as well, looking at the patient across all areas of their life, not just what happens in the home,” Hansell adds.

“Many of the questions are better in terms of being real patient issues that we have said for years complicate the delivery of home care,” Krafft judges.

“The new OASIS-E items are perfect triggers for care planning,” Tibbs says. “Identifying cognitive, mood, depression, hearing, vision, health literacy, etc., and mitigating these barriers will ultimately improve the quality of the care delivery and patient outcomes,” she believes.

Overall, “the focus on Social Determinants of Health, capturing a cognitive baseline, recognizing delirium, and expanded depression screening make it more useful in facili­tating care planning if agencies/clinicians will use the data captured,” Noyce says. “The timely health information transfer is also an excellent prompt to help agencies remember who needs to know what’s happening with the patient when he or she moves on to another care setting,” she adds.