Posted Monday, June 13, 2022
Since the inception of Star Ratings in 2015, the home health and hospice industry has emphasized the importance of OASIS accuracy as a strategy to improve scores – – and rightly so. It makes sense that the OASIS baseline must be correct, or you will not be able to accurately demonstrate patient improvement or decline.
However, if your agency is like most, you may believe that OASIS accuracy is the only strategy to improve Star Ratings. Actually, other factors are just as important to your Star Rating and Value Based Purchasing scores. When it comes to your scores, you have to think bigger.
KEY POINT: The patient must clinically improve, stay out of the hospital and report a great patient experience to land your agency on top of the Star Ratings and Value Based Purchasing game.
To arrive at OASIS outcomes, the quality episode compares Start of Care (SOC) or Resumption of Care (ROC) OASIS documentation against the transfer or discharge OASIS. What happens between those two time points, or your episode management acumen, determines whether patients have met their treatment goals and are ready for discharge.
To support discharge, the OASIS:
- must accurately reflect the status of the patient
- must apply the same quality assurance to the discharge as applied to the SOC
- must accurately record the Star OASIS M items
Getting to Better
Let the clinical staff know the measurements that are important to your agency. Then prepare them to succeed so that they can achieve the goals you set for them. Start by asking these questions to find skill and knowledge gaps where your program can improve:
- Are you analyzing the types of patients that are negatively impacting your ratings both by diagnosis and by clinician?
- Do you have routine discharge planning conference calls with clinicians to discuss patient’s progress and appropriateness for discharge?
- Do you have QAPI and education initiatives in place to identify and manage populations where the clinical staff need more guidance and support?
- Have you reviewed the impact of hospice on appropriate patients or hospice transfers for your agency? Whether hospice patients stabilize or decline can be negatively impacting your outcomes.
In addition to many clinical population variables, hospitalization rates can have a significant impact on Star Ratings and VBP scores. Have a strategy to manage hospitalizations. OASIS accuracy can help predict the patient’s risk of hospitalization, but to prevent hospitalizations, agencies must proactively implement interventions as part of episode management. Then, clinical staff must know that preventing unnecessary hospitalizations is their most important job.
Yes, you do need a strategy to address OASIS accuracy at the time points that impact the quality episode. But don’t stop there. Make sure you also appropriately develop care plans, manage episodes of care, prevent hospitalizations and improve the patient experience. When you put a comprehensive program in place that addresses the full patient episode, Star Ratings and Value Based Purchasing success follows.
Corridor’s Experts Can Help
Contact us today to get access to Corridor’s expertise in OASIS, Home Health Value Based Purchasing, Advisory & Education and more. We’ll evaluate your Star Rating and Value Based Purchasing program strategies to make sure you excel at all facets of patient care. Our quality assurance and reimbursement expertise, along with our educational programs for your staff, can help put you at the top of your class.
For over 30 years, Corridor has partnered with home-based care providers, delivering powerful solutions to support the unique challenges of caring for patients in the home. Our team of operating executives, clinicians, and nationally renowned industry experts have run provider organizations and resolved the same challenges you face.
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