HHS Ahead of Schedule with Value-Based Payment Models: Audits Can Help Agencies Prepare

To help drive the health care system towards greater value-based purchasing rather than continuing to reward volume regardless of quality of care delivered, HHS set a goal in 2015 to have 30 percent of Medicare payments in alternative payment models by the end of 2016 and 50 percent by the end of 20181. In March 2016, the Administration announced that it estimates it has already hit its first target – 11 months ahead of schedule2. There’s no doubt that the home health fee-for-service payment model is quickly being replaced with payments tied to quality of care results with increasingly rigorous scrutiny. Unfortunately, as reported in Home Health Care News, our data indicates that many home health agency staff continue to struggle with obtaining accurate OASIS assessments which will drive many outcomes, revenue and compliance activities.

Fazzi’s Compliance Division recently completed an analysis on the home health coding and OASIS audits they conducted over the past 12 months. The study revealed that on average $150-$200 per episode was not captured by agencies because of inaccurate completion of the OASIS! Furthermore, it appeared that multiple outcome measures did not show improvement because of inaccurate OASIS selection at the start of care.

Given the price of inaccurate OASIS documentation, understanding how your clinicians are handling the OASIS and which areas are most problematic is a key component to your Agency’s success.  Consider conducting a targeted record audit. Our audit will:

  1. Likely pay for itself,
  2. Tell you quickly if your OASIS assessments are accurate, and
  3. Indicate which areas should be prioritized for improvement.

Only after you know that your OASIS assessments are accurate, should you identify 1-2 QA/PI projects focused on improving quality of care measures.

Contact us about the cost and options for a focused OASIS audit.