Data sat­is­fac­tion

Home health reps say there are no OA­SIS is­sues

Modern Healthcare - - THE WEEK IN HEALTHCARE - Paul Barr

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.

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