OASIS is a clinical dataset used by CMS for assessing home care since 1999. CMS requires home care agencies to submit OASIS data for most adult Medicare and Medicaid patients. There have been widespread complaints about the time and expense required to complete the OASIS reporting form. Numerous organizations have called for streamlining of the dataset because of this administrative burden. Critics have maintained that the OASIS reporting requirements are duplicative, that the paperwork involved consumes more nursing time than that devoted to patient care, that associated administrative costs are inadequately reimbursed, and even that OASIS is partly to blame for the critical shortage of qualified home care nurses (American Hospital Association and American Home Care Association, 2001). However, there is evidence that OASIS has been a useful tool in home health quality improvement projects, resulting in measurably better outcomes for patients (Shaughnessy et al., 2002). In June 2002, the DHHS Secretary’s Advisory Committee on Regulatory Reform recommended that OASIS be subject to an independent cost–benefit evaluation. The committee also recommended that the reporting form be modernized to, for example, better reflect home health agency operations and current medical practice; to eliminate data elements that are duplicative or not used for payment, quality management, or survey purposes; and to create the option to use one form for all situations of care or changes in status (DHHS Secretary’s Advisory Committee on Regulatory Reform, 2002). In response to a request from the Secretary, CMS completed an in-depth review of all OASIS elements and has proposed reducing the burden associated with OASIS by approximately 25 percent. CMS estimates that the proposed changes could be implemented by the end of December 2002. CMS has also convened a technical expert panel and hosted a town hall meeting to assess any additional opportunities for streamlining the OASIS data collection tool (Centers for Medicare and Medicaid Services, 2002e).
CMS manages the lion’s share of the federal responsibilities for three of the government health care programs addressed in this report—Medicare, Medicaid, and SCHIP. It thereby influences the quality of health care services provided to more than one in four U.S. residents (an estimated 83 million people).