The revised OASIS item set, OASIS-C2, is scheduled for implementation on January 1, 2017. The OASIS data set is being modified to include changes related to the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act). In addition, there are formatting changes throughout the document.
Under the Paperwork Reduction Act (PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. Federal agencies also must publish a 60-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. This notice and instructions on submitting comments are available at:
The Centers for Medicare & Medicaid Services (CMS) has posted the second Quarterly Quality Assessment Only (QAO) Interim Performance Reports to the home health agencies’ CASPER folders. These new reports provide information on OASIS data submitted between January 1 and December 31, 2015. The Quarterly QAO Interim Performance Reports are informational only and are intended to assist home health agencies monitor their compliance with the annual pay-for-reporting (P4R) requirements. CMS encourages home health agencies to closely monitor these Quarterly QAO Interim Performance Reports and investigate any discrepancies or concerns in a timely fashion to assure that all corrections or adjustments occur prior to their receipt of the Annual QAO Metric Report.
The Quarterly QAO Interim Performance Reports will remain in the CASPER folders for 120 days. The table below shows the reporting schedule for 2016. More information on the QAO performance requirement is available on theHome Health Quality Reportingpage.
Quality Assessment Only (QAO) Interim Performance Report
(Available in CASPER folders)
Includes OASIS Assessments COMPLETED During
Includes OASIS Assessments SUBMITTED by
By January 31, 2016
October 1, 2014-September 30, 2015
October 30, 2015
By April 30, 2016
January 1, 2015-December 31, 2015
January 31, 2016
By July 31, 2016
April 1, 2015-March 31, 2016
April 30, 2016
Quality Assessment Only (QAO) ANNUAL Performance Report
- By October 31, 2016
July 1, 2015 –
June 30, 2016
July 31, 2016
The Quality Assessment Only (QAO) metric, was designed to measure an agency’s compliance with the OASIS reporting requirement.The new report calculates the agency’s percentage of compliance with the OASIS reporting requirement by dividing the number of OASIS assessments that can be used for quality measurement by the total number of assessments that should be used for quality measurement.
The first reporting period in which this metric will be used covers the time period from 7/1/15 through 6/30/16. The minimum compliance rate set for this period is 70%. Agencies with a compliance level below 70% will see a 2%-point reduction in their APU for CY2017.
Agencies that have problems accessing the Quarterly QAO Interim Performance Report in the CASPER folders can contact the QTSO Help Desk at 1-800-339-9313 or by email at firstname.lastname@example.org.
Agencies that have questions related to the QAO metric or the Quarterly QAO Interim Performance Reports can submit these to the Home Health Quality Help Desk mailbox at email@example.com.
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1652-P) that would update fiscal year (FY) 2017 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.
Proposed Rule Highlights
Highlights of this proposed rule include the following:
Payments - Hospices would receive a 2.0% increase in their payments for FY 2017.
Hospice CAP - For accounting years that end after September 30, 2016 and before October 1, 2025, the hospice cap is updated by the hospice update percentage rather than using the consumer price index for urban consumers (CPI-U). The hospice cap amount for the 2017 cap year will be $28,377.17, which is equal to the 2016 cap amount ($27,820.75) updated by the FY 2017 hospice payment update percentage of 2.0 percent.
Data Analysis Updates - Updated trends are provided including diagnosis reporting, pre-hospice spending, non-hospice spending, and live discharges.
Hospice CAHPS® - The Hospice CAHPS (Consumer Assessment of Healthcare Providers and Systems) Survey is a component of the Hospice Quality Reporting Program (QRP) required under the Affordable Care Act. The proposed rule outlines participation requirements for the FY 2017 and FY 2020 annual payment updates. For the FY 2019 Annual Payment Update (APU), hospices must collect survey data on an ongoing basis from January through December of calendar year (CY) 2017. For the FY 2020 APU, hospices must collect survey data on an ongoing basis from January through December of CY 2018. The proposed rule also includes survey data submission deadlines for the FY 2018, FY 2019, and FY 2020 APU periods.
2 NEW Hospice Quality Measures - The Hospice QRP is proposing two new quality measures for FY 2017. The first, Hospice Visits When Death is Imminent, is a measure that will assess hospice staff visits to patients and caregivers in the last week of life. The second, Hospice and Palliative Care Composite Process Measure, will assess the percentage of hospice patients who received care processes consistent with guidelines. This measure will be based on select measures from the seven that are currently being submitted under the Hospice QRP (Pain Screening, Pain Assessment, Dyspnea Treatment, Patients Treated with an Opioid who are given a Bowel Regimen, and Treatment Preferences & Beliefs/Values Addressed if desired by patient).
Enhanced Data Collection - CMS is considering enhancing the current Hospice Item Set (HIS) data collection instrument to be more in line with other post-acute Care settings. This revised data collection instrument would be a comprehensive patient assessment instrument, rather than the current chart abstraction tool.
Public Reporting - CMS expects to begin public reporting via a Compare Site in CY 2017. In addition, CMS expects to post hospice demographic data on a public use file at https://data.medicare.gov in late spring/early summer 2016.