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OASIS OBQM/Outcome-Based Quality Monitoring Reports

This page briefly describes the OBQM Potentially Avoidable Event Reports and Agency Patient-Related Characteristics Reports. It also holds the Outcome-Based Quality Management (OBQM) Manual (under Downloads below) which explains these two reports in detail and discusses their use for quality monitoring purposes.

  • The Agency Patient-Related Characteristics Report (formerly the Case Mix Report) presents a "snap shot" of agency patient characteristics at the start or resumption of care, and discharge information including home health length of stay and need for emergency or hospital care. It allows an agency to compare the characteristics of their patients to both a national reference sample, and to their patients during a prior time period (after the first report). The characteristics of the patients for whom an agency provides care can impact many decisions about patient care delivery, staffing, resource allocation, strategic planning and program development.
  • The Potentially Avoidable Event Report (formerly the Adverse Event Outcome Report) displays incidence rates for 12 infrequently occurring untoward events. These potentially avoidable events reflect a serious health problem or decline in health status for an individual patient that potentially could have been avoided. They serve as markers for potential problems in care because of their negative nature and relatively low frequency. It is important to emphasize the word potential in this definition. Whether or not an individual patient situation results from inadequate care provision can only be determined through investigation of the care actually provided to specific patients. Agencies can compare their current data with national data and (after the first report) to the agency's prior time period. The incidence rates been adjusted to account for variation in patient characteristics. High-priority potentially avoidable event outcomes are those with (a) the most clinical relevance to the agency, and/or (b) the highest incidence as compared to the reference group. The measures are presented in both graphical and tabular forms, along with a listing of patients for whom the potentially avoidable event occurred. This information allows the HHA to investigate specific potentially avoidable events to determine if changes in care provision are indicated.

The reports and the related investigation of care processes can be used to assist agencies move beyond "hunches" in understanding the characteristics of the patients that they care for and evaluating quality of patient care. The reports support agency efforts to continually monitor outcomes and focus efforts on specific quality indicators. Agencies are strongly encouraged to take advantage of the information presented in the reports to provide direction for their continuous quality monitoring activities.

The Outcome-Based Quality Monitoring (OBQM) Manual

  1. The Outcome-Based Quality Monitoring Manual [see Downloads section below] describes the OASIS-based reports that are available as well as the sources of information for the reports. Instructions on using the reports for quality monitoring are provided, illustrated with sample reports from a hypothetical home care agency. It is designed to help home health agencies make use of the reports for monitoring and improving quality of care.
  2. Appendix A: Guidelines for Reviewing Potentially Avoidable Event and Agency Patient-Related Characteristics Reports is presented as a technical appendix to the OBQM Manual, but can also be used as a stand-alone reference document. The guidelines include descriptions, definitions, and "How to Read" instructions for the Potentially Avoidable Event and Agency Patient-Related Characteristics Reports.

Note: The OBQM Manual is part of a series of four manuals produced by the Centers for Medicare & Medicaid Services (CMS) to assist home health agencies in the collection and use of OASIS data for quality/performance improvement. The other three manuals are available on the CMS website and include the Outcome and Assessment Information Set (OASIS-C) Guidance Manual, the Outcome-Based Quality Improvement (OBQI) Manual, and the Process-Based Quality Improvement (PBQI) Manual. These manuals are provided as downloads on the pages listed on the left side of this page as follows: OASIS –C Guidance Manual on OASIS User Manuals; PBQI Manual on OASIS PBQI / PROCESS MEASURES; OBQI Manual on OASIS OBQI; OBQM Manual on OASIS OBQM.

Accessing the Potentially Avoidable Event and Agency Patient-Related Characteristics Reports from the CASPER System

These two reports represent an aggregation of OASIS-C patient status data at the beginning and at the end of an episode of care. Since HHAs only submit OASIS-C data on Medicare and Medicaid patients, those are the only patients included in the reports. The CASPER User Manual provides information on how to obtain Potentially Avoidable Event and Agency Patient-Related Characteristics Reports from the CASPER system. It describes how to request a report, how to view a report online, and how to print or save a report. This manual can be found on each HHA's OASIS State Welcome Page. Chapter 2 (Functionality) of the CASPER User Manual is available in the Downloads section below.

Reporting Timetable

The Potentially Avoidable Event and Agency Patient-Related Characteristics Reports will be in transition between September 2010 and May 2011, while sufficient OASIS-C data are collected and risk models are developed. During that time, the reports available in CASPER will be based on OASIS-B1 data collected prior to January 1, 2010. Once the static period is over, the previous measure reports based on OASIS-B1 data will be replaced with the new OASIS-C based measure reports. An explanation of the time table for this transition can be found on the Quality Measures page, accessed via the link list on the left side of this page.

Technical Documentation for the OBQM measures

The Technical Documentation for the OBQM measures, specifying how to calculate each measure on the Potentially Avoidable Event and Agency Patient-Related Characteristics Reports using OASIS data and OASIS data specifications, will be posted once those specifications are finalized.