Final National OASIS Testing Results and What They Mean for The Future of our Industry

As you know, I love data.  It fuels understanding, learning and improvement.  Even when the data is not good, we need to know it.  And in this issue of our Benchmark newsletter, I have some eye opening data to share.

You may recall that earlier this year we provided preliminary results from the national OASIS testing project that we conducted.  This project tested agency staff competencies on OASIS across the country.  There were 57 questions covering all areas of OASIS including a special focus on Value Based Purchasing and Star Rating items.  Here are the results:

Average Score by Position











Top Problem Areas

Neuro-Emotional/ Behavioral

Therapy Need/

Plan of Care

Respiratory Status






Scores by Type of Impact

Average Score on Items with Impact on

Average Score on Items with Financial

Average Score on Items Impacting Value-Based
Purchasing Measures

& Star Ratings





The Concern

I find this data eye opening and also concerning, because OASIS is the foundation of home care.  It is the single most important tool used by clinicians to assess the clinical status of every home care patient in the country.  OASIS is used to determine reimbursement.  It is the heart of compliance reviews.  It is the foundation for Home Health Compare public reports including Star Ratings.  It is the source for comparing agencies in the new CMS Value-Based Purchasing Program.  In short, OASIS is the foundation for the entire clinical, operational, quality and reimbursement process in home care.  Given the critical nature of OASIS, these scores should be higher.

I am also concerned, because these results do not bode well for our industry being ready to succeed under Value-Based Purchasing (VBP).  I have been travelling a lot lately and speaking with many leaders of agencies and associations and I keep asking the question of why we’re not seeing a greater sense of urgency around VBP.  A few weeks ago, CMS released the first set of benchmarks and achievement thresholds to home health agencies in the nine VBP pilot states and in July they will provide these agencies with their first quarterly performance reports. VBP is here and it’s not going away.  It is the new reality for agencies in the pilot states and it soon will be for the rest of the industry.

The Good News

All of this said, I want to congratulate the agencies that participated in this testing!  They are a step ahead.  That’s because even though these agencies have improvements to make, they are much better off than agencies who don’t know where they stand with OASIS.  Whether it’s through Fazzi’s OASIS Testing, an internal or external audit, or through our VBP readiness services, the first step to making improvements is to know where you are now.   Consider this quote from author and management mentor, H. James Harrington…

 “Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.”

Our world is changing and we have to change with it.  We have no choice.  The good news is that demographics along with economic and regulatory pressures are increasing the demand for home health and hospice care.  Therefore, embracing OASIS, VBP and other changes will enable agencies to be prepared to take advantage of the growth in demand for post-acute care services.

If you have any questions about this information or would like to learn more about Fazzi’s OASIS or VBP readiness services, please contact

Bob signature



Bob Fazzi, Managing Partner

How Agencies Can Rise to the 5-Star Ratings Challenge

We want to share the white paper entitled “How Agencies Can Rise to the 5-Star Ratings Challenge”,  written based on a webinar sponsored by Homecare-Homebase and Home Health Care News.  It provides an excellent “Star Ratings 101” explanation along with insight that dovetails with this important discussion about OASIS.  We’re also pleased that our very own Gina Mazza, Partner and Director of Regulatory Compliance Services, is quoted!  You may download this paper by clicking here.