OASIS-Central

After almost a year of preparation, agencies began using the OASIS-C on January 1, 2010. For most agencies, the past year included a gradual familiarization with the revised data set, along with intense preparation for its use during the last quarter of 2009. As often happens when agencies implement a new requirement, there may have been a perception that the most difficult phase would be over once the implementation date had passed. However, since the OASIS-C includes new process measures in addition to format changes, the real work is just beginning. Anecdotal reports from agencies indicate that many are just beginning to recognize the extent to which OASIS-C may affect routine agency functions. Attention is now turning toward the process measure reporting that will begin in September 2010.

Review of process measures in OASIS-C

The original OASIS, beginning in 1999, provided the basis for standardized outcome measurement; the Centers for Medicare and Medicaid Services (CMS) used OASIS data to produce outcome reports related to the end results of home health care, as well as those related to utilization of urgent and emergent healthcare services. Adverse event reports provided additional information regarding potential problems in care delivery. Those reports set the stage for Outcome-based Quality Improvement (OBQI), an ongoing process in which agencies use the results of patient care to evaluate and improve care practices and establish best practices that others can replicate and share.

As CMS evaluated the use of OASIS data, there was recognition that other factors affected the care improvement process and that outcome data alone might not promote widespread development and use of best practices. In 2003, the Medicare Payment Advisory Commission (MedPAC) first recommended establishing a program to reward homecare providers based on quality of care. Further review of the types of measures available to evaluate quality led to identifying a need to measure certain processes employed by homecare agencies. Hoping to encourage attention to aspects of quality such as patient safety, health promotion, and risk prevention, CMS has established process measures as a way of determining whether agencies are implementing related best practices. Process measures, as noted by the 2006 MedPAC, are the “quantifiable details of what should be done, to whom, and how frequently based on best practices.”

OASIS-C is the vehicle for operationalizing process measures in seven domains: timely initiation of care, care coordination and physician notification, risk assessments, care planning for targeted areas of risk such as diabetic foot care, implementation of associated interventions, education regarding high-risk medications, and prevention activities, such as flu and pneumonia vaccinations.

This excerpt was adapted from the article “OASIS-C: Agency Integration” by Jane Miles, which originally appeared in the March 2010 edition of Homecare Administrator. Learn more about Homecare Administrator here!