In the late 1980s, the HCFA, along with the Robert Wood Johnson Foundation and later the New York State Department of Health, provided funding to the Center for Health Services and Policy Research at the University of Colorado to assess the feasibility and usefulness of measuring the outcomes of home health care.
The OASIS data set, which allowed HHAs who were already collecting assessment data to do so in a more precise form, was developed over a period of years. The original 73-item data set was first published in a report by the Research Center in 1994. The data set has gone through several iterations of expanding and refining since then, as it was anticipated at the time of initial implementation that OASIS would evolve to reflect changes in quality measurement, health research, health policy, reimbursement, and standards of care. Shortly after the data set was first published, a task force of home care experts convened by HCFA reviewed the items and recommended additional items considered essential for patient assessment. In 1995, incorporating input from the task force, the Research Center revised and rearranged the items into a data set that was called OASIS-A. This data set was used and tested in two demonstration programs in 1995 and 1996. The demonstration programs suggested select refinements which resulted in OASIS-B. Subsequently, OASIS-B was modified slightly to take into account HCFA's needs for data management and administration. The version containing these modifications was released in 1998 and was referred to as OASIS B-1. Further revisions were made to OASIS B-1 in 2007 to support the revised PPS effective January 1, 2008.
As of December 31, 2005, the Colorado Outcome Reporting and Enhancement (CORE) Research Partnership, which appears to have been an extension of the Research Center's (now the Center for Health Services Research) work with OASIS, ceased operations.101
Development of modifications to the OASIS-B1 instrument began in 2005 following input from a variety of stakeholders that included industry feedback, recommendations from the National Quality Forum (NQF), and an expert panel who identified best practice process measures. In September 2006, CMS contracted with Abt Associates and subcontractors from the University of Colorado Health Sciences Center and Case Western University to help CMS refine the OASIS data set.102 Earlier recommendations, along with a major effort to align OASIS measures with those of other assessment instruments, including the Minimum Data Set (MDS) and the Continuity of Care Record Evalution (CARE) tool, formed the basis of the OASIS revisions. CMS viewed the revision as an opportunity to address quality of care across the health care continuum as patients moved among health care settings.
OASIS-C testing was completed in 2008 and a revised instrument revision posted in November 2008. After a comment period that ended in January 2009, a revised final version was submitted to the OMB in compliance with the Paperwork Reduction Act, and after receiving OMB approval, posted to the CMS web site August 12, 2009.103
"StratEng.pdf" (pdf, 1.74Mb)
"StratEng-A.pdf" (pdf, 198.14Kb)
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