OASIS Alert

New year also brings CMS demo project.

Pay for performance is coming and home health agencies that don't jump on the train soon will find it running over them.

The basics: Congressional legislation requires home health agencies to report quality data to receive their full inflation update in the 2007 Medicare payment rates. The Centers for Medicare & Medicaid Services issued its final rule implementing the 2007 rates and has included a provision requiring a 2 percent re-duction to the prospective payment system rate for HHAs that fail to submit OASIS data.

Basic Requirement Encourages Success

Sometimes called "pay for reporting," this is the next step in the plan to fully implement P4P for HHAs. Pay for reporting should be easy for most agencies, experts predict. Only about 1 percent of certified agencies fail to report OASIS data, says clinical consultant Judy Adams with Charlotte, NC-based LarsonAllen. And CMS will require only one data submission during the relevant time period to qualify an agency for the full rate increase, reported CMS' Mary Weakland during the Nov. 8 Home Health Open Door Forum.

Beware: This minimal level of reporting needed to qualify "may change in subsequent years," Weakland said.

Regional home health intermediaries will be responsible for notifying providers if they are ineligible for the full rate increase because they fail to meet the reporting requirement, CMS said in the forum.

CMS P4P Demo Info Coming Soon

The next stop for the P4P train is the CMS demonstration project. Contractor Abt Associates is in the process of completing the demo design, CMS announced at the Nov. 8 ODF and a Special Open Door Forum on the demo is planned for Dec. 13.

Details of the demo design may help agencies predict how home health P4P will look. The project is scheduled to begin in October 2007 and end in 2010, CMS said.