“They Are Measures Without Impact”: Home Care Social Workers Criticize OASIS-E

Abstract

There is significant literature about the Medicare Outcome and Information Assessment (OASIS). A new OASIS Version E, effective January 2023, makes significant changes in assessing patient mental health. However, a literature review indicates no studies of the anticipated effectiveness of the OASIS-E on improving psychosocial care of Medicare home health beneficiaries. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 36 home care social workers from 5 different home health agencies in the New York City metropolitan area between August 1, 2022, and November 30, 2022. Four themes emerged from the study, namely that social workers believe the OASIS-E revisions: are an improvement over prior OASIS versions; are cumbersome and do not require administration by a social worker; do not impose specific guidance requirements on using new measures scoring results in making care decisions; and do not address coverage of specific interventions that address patients with significant mental health issues. Policymakers are urged to modify the OASIS-E guidance manual to require use of new mental health assessment scores in care planning and to expand coverage of evidence-based treatment interventions for patients with significant assessed mental health conditions.