The home health quality measures are based on data collected on adult non-maternity home care patients getting skilled services whose care is covered by Medicare (both fee for service and managed care) or Medicaid and provided by a Medicare-approved home health agency. The information on process and improvement outcome measures posted on Home Health Compare comes from the Outcome and Assessment Information Set (OASIS) quality data submitted by home health agencies to state repositories and stored in the Quality Improvement Evaluation System (QIES) database. The information on utilization measures posted on Home Health Compare comes from Medicare claims.
The Outcome and Assessment Information Set (OASIS). The OASIS data are used to calculate the home health quality measures (both outcome and process measures) and determine the service area for each home health agency in the home health compare search function.
OASIS is a group of data elements that represent core items that are included in a comprehensive assessment for each adult home care patient. These core items and the larger comprehensive assessment serve as the basis for the development of the plan of care and ongoing management of the patients. The OASIS also forms the basis for measuring patient outcomes for purposes of Outcome-Based Quality Improvement (OBQI) and agency adherence to best practices for Process-Based Quality Improvement (PBQI). The OASIS is a key component of Medicare's partnership with the home care industry to foster and monitor improved home health care outcomes. Additional state-specific measure information on OASIS may be found at the OASIS home page.
- Quality Improvement Evaluation System (QIES). The QIES encompasses all the aspects of data collection and reporting on home health agencies. Some of the information about home health agencies is collected and maintained by the State Survey Agency, found in Medicare Helpful Contacts under Home Health Agency, that's operated by each state’s government. For each agency, this information includes the home health agency’s name, address, phone number, services offered and type of agency. The state survey agencies are responsible for entering this information into the QIES database and providing updates as needed. The QIES database also includes all OASIS assessment information submitted by home health agencies to their State Survey Agency. CMS will migrate the QIES system to iQIES in 2020. For more information please link to: https://qtso.cms.gov/software/iqies/faqs.
- Medicare claims. Medicare claims data are used to calculate certain utilization-based home health quality measures. In order to be paid for services they provide for Medicare Part A and B beneficiaries, providers must submit claims for every patient they encounter. Claims data include patient identifiers, provider identifiers, services rendered, diagnoses, and payment, and additional detailed information. Claims data are reliable because providers are required to submit claims to get payment.
We work to be sure that the OASIS, QIES/iQIES, and claims information is correct and current. However, we recommend you look at this information carefully. Use it with other information you gather from the State Survey Agency, state QIO and from other sources when you choose a home health agency. You may also want to talk to your doctor or home health agency staff.