Home health reps say there are no OASIS issues
Representatives of the home health industry say they are satisfied with the quality of the post-acute segment’s clinical data submissions, disputing a critical report from HHS’ inspector general’s office.
The inspector general’s office on Feb. 28 released a 22-page report that said home health agencies are not turning in their Outcome and Assessment Information Set data, as required, and the CMS could do a better job of making sure that they do. Inspector general’s office analysts estimated that in 2009, one of the periods examined, home health agencies did not submit required OASIS data for 6% of all claims, which represented more than $1 billion in Medicare payments. Meanwhile, the CMS is assessing a mandated 2% reimbursement penalty to less than 1% of all home health agencies.
The issue of getting quality data is gaining significance as federal efforts encourage the use of reimbursement and care models that rely on clinical data, such as bundled payments and value-based purchasing. Moreover, the OASIS data are used in the CMS’ Home Health Compare website. “Timely and accurate submission of these data is vital” for home health agencies’ efforts to improve quality and for consumers researching them, according to the report, called Limited Oversight of Home Health Agency OASIS Data. The report largely blames the CMS for not preventing the problems.
But officials for the home health industry say there are no significant OASIS problems and agree with the CMS’ published response that the majority of agencies are turning in OASIS data. Mary St. Pierre, vice president for regulatory affairs at the National Association for Home Care & Hospice, said numbers highlighted in the CMS’ response support her belief that reporting is not an issue. The CMS responded that 85% of home health agencies are reporting within the 30-day time limit and another 10% are reporting within 10 days after that.
Having 95% of agencies reporting within 40 days is a good result, given the complicated nature of what they have to report, while the 30day target is an arbitrary number, St. Pierre said.
Executives at home health and hospice company Amedisys, Baton Rouge, La., said the OASIS reporting framework seems to be working well. Amedisys has an automated approach to reporting using laptops and tablets that allows it to report OASIS data within three days for its agencies, said Leigh Ann Witcher Templeton, vice president of office informatics.
The CMS said in its response that it was going to make claim reimbursement dependent on data submission and it would raise the requirements for home health agencies to avoid the 2% penalty, as suggested by the report. The CMS did not agree with recommendations that it more aggressively pursue late reporters of data or attempt to review state protocols and procedures for reporting OASIS data.