OASIS Alert

Get a jump on upcoming outcome changes.

If home health quality seems like a moving target, that's because it is one. You may want to focus your next outcome-based quality improvement effort on one of the measures about to debut as a publicly reported measure.

Now that many agencies are beginning to show improvement on Home Health Com-pare measures, the Centers for Medicare & Medicaid Services has decided to change them. A new version of Home Health Compare will debut in 2005 and new measures will replace four of the current ones, a CMS staffer reported at the Dec. 15 Home Health Open Door Forum.
 
The National Quality Forum should provide CMS with a final list of new measures it is endorsing for public reporting (see OASIS Alert, Vol. 5, No. 10) sometime between March and June, the CMS official said in the forum. Meanwhile, CMS will be working on the OASIS-based recommendations the agency plans to have ready for the 2005 changes to Home Health Compare, she explained.
 
CMS expects to debut the new version - and launch a Spanish version - in late summer or early fall, the staffer added. As with the original Home Health Compare measures, CMS will develop and test consumer language before adding the measures to the public site.

Heads up: CMS "tentatively plans to stop reporting" the following measures, the official announced:

1. Improvement in upper body dressing

2. Stabilization in bathing

3. Improvement in toileting

4. Improvement in confusion frequency

CMS will substitute these measures for the four deleted items, the official announced. These require only the data agencies are already gathering, CMS said:

1. Improvement in status of surgical wounds

2. Improvement in urinary incontinence

3. Discharge to community

4. Improvement in dyspnea

Other Changes Take Longer

CMS is aware of concerns about the OASIS tool itself, the official acknowledged, and "is working on it." The agency has "collected many recommendations for fairly extensive changes," she reported, but changes would need to be tested before CMS could adopt them. Changing the OASIS tool is a longer process than changing the public reporting, she told forum attendees.

In addition, the University of Colorado is conducting research on about 20 other non-OASIS-based quality measures the NQF tentatively recommended, and which CMS "is very interested in," the CMS official announced. Researchers are looking for ways to integrate some of the measures into OASIS, she said.
 
Don't miss: CMS updated the Home Health Compare Web site Dec. 2. The national average improved on four items and stayed the same on the other seven.