OASIS-D: The Devil in the Detail

The next generation of OASIS, OASIS-D, will go into effect on January 1, 2019. The changes are significant and could adversely impact publicly reported outcomes, Star ratings, value-based purchasing measures and reimbursement.

Learn How Fazzi Can Help Your Agency Prepare for OASIS-D

Potential Impact on Risk Adjustment
Some of the items being removed are used to calculate risk adjustment currently. We assume that CMS will need to take a fresh look at how risk adjustment is applied since these M-Items will no longer be available to use when calculating outcomes. There’s no way to correlate improvements or declines using the new OASIS items since the questions have never been on the OASIS before and statistical significance cannot be calculated. If risk adjustment isn’t revised, all the remaining OASIS responses used to calculate risk adjustment might now exert a greater percent of impact on outcomes. Therefore accurate OASIS responses are critical to ensure accurate outcome numbers.

Because of the items being removed, a patient could show less of a risk adjusted improvement. Therefore agencies could see a decline in risk adjustment in these areas:

Publicly Reported Outcomes Where Risk Adjustment May Be Lost Star Ratings Where Risk Adjustment May Be Lost
  • Improvement in Pain (M1242)
  • Improvement in Status of Surgical Wounds (M1342)
  • Improvement in Dyspnea (M1400)
  • Improvement in Bathing (M1830)
  • Improvement in Bed Transfers (M1850)
  • Improvement in Ambulation (M1860)
  • Improvement in Oral Medication Management (M2020)
  • Improvement in Pain (M1242)
  • Improvement in Dyspnea (M1400)
  • Improvement in Bathing (M1830)
  • Improvement in Bed Transfers (M1850)
  • Improvement in Ambulation (M1860)

Areas of Potential Overlap, Duplication and Confusion
With the addition of the new GG functional items, there are several areas of potential overlap and duplication with existing M-Items. Because the items are similar but not the same, they are cause for confusion and therefore inaccuracy. For example:

Exsisting M-Items Similar but Not the Same as These New GG Items
  • Ability to dress upper body (M1810)
  • Ability to dress lower body (M1820)
  • Bathing (M1830)
  • Toileting hygiene (M1845)
  • Feeding or eating (M1870)
  • Self-care (GG0130)
  • Toliet transferring (M1840)
  • Transferring (M1850)
  • Ambulation (M1860)
  • Mobility (GG0170)
  • Grooming (M1800)
  • Oral Hygiene (GG0130)

Dependent to Independent Sequencing Differences
Another area for potential confusion is the different scales for scoring patients. For the M-Items, Independent is captured in response ‘0’ but for the GG-Items, Independent is at the other end of the scale as response ‘06’.

In Conclusion
OASIS-D cannot be taken lightly or ignored until December. Planning now will protect outcome scores, Star ratings, and reimbursement. If you’d like information on how Fazzi can help your agency with the transition to OASIS-D, please click below.

Learn How Fazzi Can Help Your Agency Prepare for OASIS-D