Challenge
Since 1999, the Conditions of Participation (CoPs) at § 484.55 have mandated that Home Health Agencies (HHAs) use the Outcome and Assessment Information Set (OASIS) when evaluating adult non-maternity patients receiving skilled services. The OASIS is a core standard assessment data set that agencies integrate into their own patient-specific, comprehensive assessment to identify each patient’s need for home care that meets the patient’s medical, nursing, rehabilitative, social, and discharge planning needs.
In support of the IMPACT Act of 2014 (the Act), and the Centers for Medicare & Medicaid Services (CMS) Quality and Quality Improvement Organization (QIO) Program, CSM sought services to maintain, re-evaluate, and implement changes to the OASIS data item set and also to develop, implement, maintain, and re-evaluate quality measures (such as outcome, process, and structural and composite quality measures) which are reflective of quality care provided by HHAs in the home setting.
Solution
Atlas Research partnered with Abt Associates to conduct an environmental scan and a gap analysis on Outcome and Process measures for CMS. The environmental scan will review the most current literature related to the existing OASIS Outcome and Process Measures to provide an assessment of the strength and utility of each measure. The environmental scan will also assist in identifying any gaps in current OASIS measures and provide CMS with recommendations for potential new metrics.
The scan focuses on identifying any maintenance measures for re-engineering; recommending expansion of measures to other settings/populations for program alignment; and recommending potential updates for measures due to new scientific evidence, unintended consequences, and other evidence supporting modifications or updates.
In addition, Atlas will perform an evaluation of the Home Health quality reporting program and Home Health Compare reporting program to provide expert input as to the implementation of a 5-Star quality rating system method of reporting the Home Health quality measure data.
Result
Atlas leveraged its knowledge and 20+ years of expertise in quality measurements, clinical care delivery, and health system industry best practices to facilitate the project coordination and implementation of the environmental scan and gap analysis.