You need to make sure that you get reliable healthcare for any medical problems that you are dealing with. Medicare is one of the biggest insurers that many people rely on. We have an article on the importance of understanding Medicare, but you need to know how to deal with upcoming changes.
In 2023, the Centers for Medicare & Medicaid Services (CMS) conducted a review of the OASIS assessment item set to identify which items could be removed to lessen the burden of data collection. The review considered several factors, including:
– Items used for measures in the Home Health Quality Reporting Program (HHQRP).
– Items involved in the Home Health Prospective Payment System (PPS).
– Items utilized in the Medicare certification survey process.
– Items used for the Home Health Value-Based Purchasing (HHVPB) demonstration.
– Items critical for risk adjustment.
– Items added to fulfill data categories in the Conditions of Participation.
Following this review, CMS announced minor updates: some OASIS elements will be removed, some revised, and a new element added. Anyone seeking open enrollment for Medicare needs to understand these changes. These modifications are minimal compared to those made in CY 2023.
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Removal of OASIS Items
Effective January 1, 2025, the following OASIS items will be removed:
– M0110 – Episode Timing: This has been removed as it is no longer utilized in the Home Health Quality Reporting Program, nor is it needed for CMS payment, surveys, or the expanded HHVBP Model.
– M2200 – Therapy Need: This item is removed for the same reasons as Episode Timing.
– GG0130 & GG0170 – Discharge Goal: Both items are removed to align with the upcoming changes to the HHVBP model that will take effect in 2025.
Revised OASIS Items
As of January 1, 2025, the following OASIS items will be revised:
– M0150 – Current Payment Source: This item’s specifications will now allow OASIS assessments to be submitted with responses that indicate non-Medicare or non-Medicaid sources.
– D0150 – Patient’s Mood Interview: This item will have updated instructions to align with new guidelines.
– M2420 – Discharge Disposition: The instructions have been revised to align with updated guidance.
– M0102 – Date of Physician Ordered Start of Care (Resumption of Care): This item’s skip pattern will be adjusted due to the removal of M0110 – Episode Timing.
Addition of OASIS Item
Effective January 1, 2025, the following OASIS item will be introduced:
– O0350 – Patient’s COVID-19 Vaccination Status: This new item is added to support the COVID-19 vaccine quality measure included in the final rule.
Impact of OASIS-E1
The changes in OASIS-E1 for CY 2025 will have a minimal effect on home healthcare agencies. While the removal of certain items may reduce assessment time, clinicians may need to spend additional time gathering information about patients’ COVID-19 vaccination status.
Preparation for Agencies
Despite the minor changes, home healthcare agencies will need to educate their clinicians and ensure that their home healthcare software is equipped to handle these updates.
Education and Training
Agencies will need to provide training for clinicians on the changes, particularly regarding procedures for collecting the COVID-19 vaccination status.
Policies and Procedures
Agencies should review and update existing policies and procedures to meet the new requirements, including establishing processes to ensure accurate documentation that supports the HHVBP model.
Software Platform
Home care agencies must adapt to meet the requirements of OASIS-E1 changes for CY 2025. Agencies should consult with their software vendors to confirm compatibility.
