" They worked very hard on my case and got me a very, very favorable outcome "
Home healthcare services are covered under Medicare Part A. They’re an important, lifesaving type of care that helps seniors remain in their own homes for as long as possible. In order to make sure that the elderly are getting the possible level of care, the Centers for Medicare and Medicaid (CMS) use the Outcome and Assessment Information Set (OASIS). This assessment collects information about the agencies that provide home healthcare services. Federal, state and local agencies use the data from OASIS assessments in order to plan programs, improve the quality of care and track whether or not the service providers are meeting their obligations and objectives.
The OASIS is a tool that enables home healthcare agencies to collect information about the care they provide to their patients. The assessment includes about 100 data elements about each patient. If more than one patient in a household receives home healthcare services, an OASIS assessment is performed on each of them. The purpose of these assessments is to improve the quality of the care provided by home health agencies. The agencies, state health departments and CMS use the results for selecting partners and informing patients about their care options.
The OASIS data elements include patient demographics, service needs, functional status and clinical status. In 2021, CMS added additional questions about COVID-19 health services to the OASIS assessment. The categories of data collected by OASIS are:
The demographic questions in the OASIS assessment include
The data elements on the OASIS assessment related to service needs include
The types data elements collected in the clinical status portion of the OASIS assessment:
The functional status questions on the OASIS assessment relate to a person’s ability to function independently. OASIS collects information about:
Since 1999, CMS has required all home healthcare agencies with Medicare certifications to collect OASIS data for all adult patients. They must also transmit the data in a timely manner. Home healthcare agencies don’t have to collect information about all of their patients. CMS exempts patients who are under the age of 18, those who are receiving maternity care and those who only receive housekeeping services.
CMS uses OASIS information to prioritize funding and different types of healthcare services. For example, if there’s an increased need for housekeeping among elderly patients who are recovering from fractures, the agency can plan around this. The information is also used to improve the quality of care patients receive. If CMS pays for intensive home healthcare services, but the patients are not experiencing any improvement, this suggests that the home healthcare agency may need to restructure its services, retrain its employees or realign its services with what its patients need.
Anyone interested in viewing OASIS results can visit the CMS website or their state health department’s website. For example, the Ohio Department of Health posts results that pertain to Ohioans who receive home healthcare services. The results are de-identified and only presented in aggregate.
States and the federal government use the information from OASIS assessments to determine reimbursement rates for home health agencies. If an agency receives a low rating, it may not get the maximum amount of reimbursement. States and the federal government also post the results publicly so that people can compare different home health agencies before choosing one to care for their family member or themselves. OASIS results give patients and families an opportunity to make informed decisions.