NAHC Report 2011. Copyright National Association for Home Care and Hospice, Inc (www.nahc.org) .— Reprinted with permission
NAHC Report Article
Friday, September 2, 2011
________________________________________ CMS Posts OBQI Risk Adjustment Models OASIS National Repository Assessment Data Used
The Centers for Medicare & Medicaid Services (CMS) released the long awaited document describing Outcome Based Quality Improvement (OBQI) risk adjustment. It provides descriptions of the prediction models used to risk adjust outcome rates presented in home health agency outcome-based quality improvement (OBQI) reports that replace the prediction models used to risk adjust outcomes based on the OASIS-B1 assessment instrument.
The models presented in this document were developed using OASIS national repository data from assessments submitted between January 1, 2010 and September 30, 2010. Using this logistic regression model CMS will predict outcome results for three utilization outcomes, 22 functional improvement outcomes, 11 functional stabilization outcomes, and 12 potentially avoidable events. The model was created using assessment data from January 1, 2010 through September 30, 2010 (nearly three million episodes of care). Additional risk factors based on each response option level for each OASIS-C item were computed. From this analytic file, two developmental samples of 250,000 episodes of care were randomly selected, along with a validation sample of 1,000,000 episodes of care.
NAHC Urges Home Health Agencies to Analyze OASIS Data Collection and Submission The National Association for Home Care & Hospice (NAHC) recently learned that at least one contractor for the Centers for Medicare & Medicaid Services (CMS) has begun auditing home health claims for OASIS data submission during the conduct of medical review. In cases where OASIS start-of-care or recertification data for episodes under review were not submitted to the state, claims were denied in full. Up to this time, penalties for failure to submit OASIS data have been limited.
NAHC Report 2010. Copyright National Association for Home Care and Hospice, Inc (www.nahc.org) .— Reprinted with permission.
Update from NAHC Regulatory Affairs: OASIS-C Assessment Tool The Centers for Medicare & Medicaid Services submitted the next version of OASIS, entitled OASIS-C, to the Office of Management and Budget (OMB) for review and approval. Since CMS has not yet posted the entire packet with supporting statement on its Paperwork Reduction Act website, NAHC is providing the OASIS-C assessment tool only for review at this time. Once the entire OMB packet becomes available NAHC will post it to their list serve.
To be assured consideration, comments and recommendations must be submitted in one of the following ways by January 13, 2009: 1. Electronically. You may submit your comments electronically to http://www.regulations.gov. Follow the instructions for ‘‘Comment or Submission’’ or ‘‘More Search Options’’ to find the information collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following address: CMS, Office of Strategic Operations and Regulatory Affairs, Division of Regulations Development, Attention: Document Identifier/OMB Control Numberllll, Room C4–26–05, 7500 Security Boulevard, Baltimore, Maryland 21244–1850.
The National Association for Home Care & Hospice (NAHC) received a question from a provider as to whether a home health agency may have speech-language pathologists (SLP) do the initial and comprehensive assessments in physical therapist (PT)-only cases. The agency that inquired is suffering from a shortage of nursing and PT staff. Their PTs do not do OASIS comprehensive assessments. However, the agency does have SLPs available to do the initial and OASIS comprehensive assessments for PT only cases. NAHC Report - reprinted with permission.