Home Health Billing Update: The OASIS-E Launch is Coming

If you’re preparing for home health billing and home health coding strategy updates in 2023, now is the time to catch up on OASIS-E updates and how organizations like yours should get ready. The short answer is that the launch is scheduled soon, and that outsourced home health solutions might help fill in any gaps you have or address concerns.

OASIS-E and its Home Health Billing History
OASIS is the Outcomes and Assessment Information Set used by healthcare clinicians to assess patient care quality and outcomes. It’s been an evolving information set, shifting to keep up with regulatory requirements and industry needs. Launched in 1999, it has been a subject of debate regarding its reliability and validity in terms of outcomes measurements and research.

It collects information on around 100 items in relation to a home care recipient, including demographic information, functional status, clinical status, and their service needs. It is completed for all Medicare and Medicaid, non-maternity and non-pediatric beneficiaries at admission, discharge, transfer, and change in condition. Data is collected by a home care clinician, this can include a nurse or therapist, through interview and direct observation of a care recipient and can also involve a caregiver. Some indicators are used to assign a patient to a Home Health Resource Group (HHRG) [1].

OASIS has been through multiple versions including OASIS, OASIS-B, OASIS-B1, OASIS-C, and OASIS-D. The new release, OASIS-E, scheduled for implementation on January 1, 2023, can pose a challenge for the practitioners using it, even if they do have a fundamental understanding of OASIS as it exists today.

The OASIS-E Launch for Home Health Billing
The launch of OASIS-E has been delayed because of the COVID-19 public health emergency, but 2023 has been slated for its inception to align with expansion of the Home Health Value-Based Purchasing (HHVBP) Model. Know that adapting to this update will have a direct impact on your payments, cash flows, and patient outcomes, so it’s critical that your OASIS data accurately reflects the status of your home health patients.

Some industry experts see the update as one of the biggest changes in recent years. This new version ushers in updates including:

For providers interested in a preview of what life will be like under OASIS-E, it can be helpful to look to skilled nursing facilities (SNFs) since they’ve already been keeping up with many of the standards. As of February, of this year, around 40% of agencies didn’t have a plan for OASIS-E education, but 15% were planning on beginning education sometime this year. A full 55% were planning on training that involved hybrid online and in-person methods.

How to Prepare Your Home Health Billing for OASIS-E
If you haven’t started preparing for OASIS-E, know that now is a great time to begin. As the industry sees historic growth and an ongoing challenge of workforce shortages, things will only get more complex with time. Here are a few tips to move forward [2].

Master OASIS-D1
If you haven’t already, make sure that your agency has a solid understanding of the transitional aspects of OASIS-D1. This will pay off in implementation of OASIS-E, but will also help you improve engagement, clinician insight, and satisfaction. Timing of your transition is critical, since training too early can mean clinicians are waiting to implement, but this late in the year, you have fewer concerns.

Keep in mind that this is also an opportunity to redesign your training programs so that they’re more in line with a continuous approach to education and that they foster a culture of competence and confidence in OASIS use. Instead of addressing it as a form that needs to be completed, help your clinicians engage with deeper understanding of the data elements that underlie OASIS and how each of them connects to their patient care responsibilities.

Focus on Accuracy and Timeliness
As the industry emphasizes more value-based results, comprehensive and accurate assessment of your OASIS data will only become more important. This means that you will need to complete your assessments on time and ensure they’re accurate or you could face snowballing errors and inefficiencies. These can easily turn into incorrect billing, ineffective care plans, and lost revenue – even errors in patient care.

Start Now
Again, now is the time to prepare for OASIS-E. Consider steps including:

  • Assessing agency health, including operational efficiency
  • Making sure your home health billing and home health coding OASIS review partners are as focused on data and performance insight as you are
  • Establishing EHR documentation best practices
  • Marking your baselines so you can more easily identify knowledge gaps
  • Layering OASIS-E data guidance through the end of the year
  • Encouraging your leaders to learn more about the transitional relationship between the data elements of OASIS-D1 and OASIS-E

While OASIS-E preparation might seem burdensome, know that the right approach can yield a world of benefits, including better engagement, increased cash flows, and an easier transition to value-driven initiatives. To help identify the home health solutions that can support your transition to and growth within OASIS-E, we invite you to contact us today.

[1] M. O’Connor and J. K. Davitt, “The Outcome and Assessment Information Set (OASIS): A Review of Validity and Reliability,” Home Health Care Serv Q, vol. 31, no. 4, p. 267–301, 2012.
[2] V. Johnson and C. Campbell, “3 Steps to Take Now to Prepare for the 2023 Launch of OASIS-E,” Cahaba Media Group, Inc., 8 June 2022. Available: https://www.homecaremag.com/june-2022/3-steps-take-now-prepare-2023-launch-oasis-e.

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