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The Outcome-Based Quality Improvement (OBQI) program provides reports to all Medicare-certified home health agencies so that they can identify potential quality problems and devise appropriate strategies to address them. There are 41 OBQI quality measures. A data-driven "stepwise" approach currently is used to risk adjust the OBQI indicators with a separate set of risk factors included in the risk-adjustment model for each outcome. The purpose of this project was to use a theory and evidence-based approach to develop and test alternative risk-adjustment models for the OBQI quality indicators within the frame of the existing OASIS instrument. [114 PDF pages]