Concluding Observations

With the implementation of a prospective payment system, efforts to protect patients from potential underprovision of care and to hold HHAs accountable are essential. Instituting the collection and reporting of OASIS data is an important step in that direction. The use of OASIS data enhances consistency in the performance and documentation of patient assessments for home health services. As a result, information on patient outcomes will become available for the first time. Collecting such data is not without its costs. To varying degrees, the requirement to collect OASIS data on all home health patients increases the amount of staff time devoted to collecting and reporting patient assessment information. HHAs have been compensated for some of these costs through adjustments to their payment rates. Moreover, because PPS episode payment rates are based on historically high utilization levels, which have since declined, these rates should allow the completion of OASIS assessments. Protecting the privacy of home health care patients is also important. HCFA has made progress in this area by enhancing protections in the collection and transmission of the OASIS data. The effectiveness of these policies and procedures will depend on how well they are implemented.
What GAO Found

With the Health Care Financing Administration's (HCFA) implementation of a prospective payment system, efforts to protect patients from potential underprovision of care and to hold home health agencies (HHA) accountable are essential. Instituting the collection and reporting of Outcome and Assessment Information Set (OASIS) data is an important step in that direction. The use of OASIS data enhances consistency in the performance and documentation of patient assessments for home health services. As a result, information on patient outcomes will become available for the first time. Collecting such data is not without its costs. To varying degrees, the requirement to collect OASIS data on all home health patients increases the amount of staff time devoted to collecting and reporting patient assessment information. HHAs have been compensated for some of these costs through adjustments made to their payment rates. Moreover, because prospective payment system episode payment rates are based on historically high utilization levels, which have since declined, these rates should allow the completion of OASIS assessments. Protecting the privacy of home health care patients is also important. HCFA has made progress in this area by enhancing protections in the collection and transmission of the OASIS data. The effectiveness of these policies and procedures will depend on how well they are implemented.