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Preparing for OASIS-E: A Step-By-Step Guide

    In the face of the shifting home health landscape and in anticipation of the implementation of the OASIS-E and expanded Home Health Value-Based Purchasing (HHVBP) on January 1, 2023, home health agencies must focus on the best ways to prepare for it. The industry’s transition from OASIS-D1 to OASIS-E aims to better align with other post-acute providers’ data collection and care delivery to ultimately improve patient outcomes.

    The shift to OASIS-E supports initiatives by the 2014 Improving Medicare Post-Acute Care Transformation Act. There are 6 new categories in OASIS-E that support the implementation of the standardized patient assessment data elements (SPADEs). OASIS-D1 already added two SPADEs elements, namely, GG: Functional Status and J: Incidence of Falls. While the OASIS-E data set has a different flow, there is a significant number of OASIS-D1 data elements that remain.

    How to Prepare for OASIS-E

    Here is how you can optimize your approach to preparing for OASIS-E:

    1. Ensure OASIS-D1 competence

    75% of the information in OASIS-E is already in OASIS-D1 thus, one of the best ways to prepare for the shift is to first ensure mastering the transitional aspects of OaASIS-D1 before proceeding to train for OASIS-E. Not only will this lay the foundation for making the implementation of OASIS-E easier, but it will also help improve agency outcomes on all fronts. Training too early for specific OASIS-E items may be in vain, as clinicians will not be putting them into practice for months. 

    1. Evaluate your current processes using data

    These are ways to do it:

    • Identify the most common OASIS-D1 challenges.
    • Have a QAPI program solely focused on improving outcomes.
    • Evaluate OASIS comprehensive assessment forms by eliminating redundancy and ensuring the assessment is set for accurate coding and OASIS-E.
    • Analyze OASIS and outcome reports to implement OASIS-D1 training based on clinicians’ current OASIS performance.
    • Utilize technology and online resources for OASIS-E training.
    • Leverage the support of your electronic health vendor in the implementation of OASIS-E and the timing of the updates.
    1. Refresh your educational approach

    There are many opportunities in the transition from OASIS-D1 to OASIS-E. One is for agencies to reevaluate their training programs and possibly redesign them more continuously to establish OASIS competence and confidence among clinicians. They must be encouraged to go beyond the surface of filling out the form and analyze the underlying data elements and their importance. This will ultimately affect employee engagement and retention positively.

    1. Start preparation at a foundation level for OASIS-E now

    Below is a list of how to go about it:

    • Assess your agency’s operational efficiency.
    • Establish electronic health record documentation best practices and use analytics to help with clinical decision-making.
    • Perform OASIS baseline testing to identify gaps in knowledge.
    • Perform objective OASIS competence measurements in the field and make sure your preceptors teach the same information.
    • Train staff to help them stack skills and improve competence over time.
    • Get the timing right by building OASIS-D1 competence now by including OASIS-E-specific data guidance throughout the second half of 2022.
    • Leaders must familiarize themselves with the transitional relationship of the data elements between OASIS-D1 and OASIS-E. The rearrangement of sections and addition of new data elements might affect assessment techniques, which may require training on the Confusion Assessment Method and Brief Interview for Mental Status assessment.
    • Get the ball rolling on initial education on the new OASIS-E-specific data elements, but not too early, as clinicians will need to retain the new information in 2023.

    Ensure that your agency’s coding and OASIS review partners and processes are data-driven and focused on building performance insight.

    Leverage Your OASIS QA Program

    Redesigning your OASIS approach will improve efficiency as less time will be spent on improvements in your business and programs. However, this may take some time because it would be impossible for clinicians to get everything right with all the elements and factors involved in the documentation. Your QA program will greatly help ensure the accuracy of your documentation and optimize your reimbursements despite all the changes in the data sets and payment mechanisms. Make sure your QA team or provider is knowledgeable of new compliance standards to maintain quality and efficiency in your clinical back-office functions.

    Accuracy and Timeliness Are Key

    Assessment and OASIS data that are comprehensive and accurate are essential in demonstrating value-based performance in health care. Needless to say, if they are not, this may result in inefficiencies and errors, which may then snowball into ineffective care planning, incorrect billing, the loss of hard-earned revenue, and other more potentially serious patient care errors. Therefore, clinicians need to understand how OASIS has a substantial impact at the start, resumption, and discharge.

    Riding the Tides of Change

    Your efforts today in navigating the home health landscape are critical to your position and success in the competitive market moving forward, as home health is now more value-driven and the post-acute space becomes more collaborative. Realigning your perspective on OASIS training and excellence to your goals is a great way to move towards a positive performance trajectory in 2023.

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