The GG (General Information) section of the OASIS assessment form directly impacts revenue under HHVBP (Home Health Value-Based Purchasing) through its influence on the calculation of certain quality measures. Here’s how:
1. Patient Characteristics:
- GG001: Patient’s age: Older patients may have more complex health conditions, leading to increased care needs and potentially higher revenue.
- GG002: Gender: While not directly correlated with revenue, gender can indirectly impact care needs and costs.
- GG003: Race/Ethnicity: Similar to gender, race/ethnicity can influence health disparities and care requirements.
2. Socioeconomic Factors:
- GG004: Marital status: Married patients may have more social support, potentially impacting care needs and costs.
- GG005: Educational level: Higher education may correlate with better health literacy, leading to more effective care and potentially lower costs.
- GG006: Primary payer: The type of insurance coverage can significantly impact reimbursement rates and revenue.
3. Living Situation:
- GG007: Living arrangement: Living alone or with family can influence care needs and costs.
- GG008: Living situation: Whether the patient lives in a private residence or a facility can affect care requirements and expenses.
4. Functional Status:
- GG010: Cognitive status: Impaired cognitive function may require more intensive care, leading to higher costs.
- GG011: Physical limitations: Mobility impairments can necessitate more frequent visits and specialized care, increasing expenses.
How these factors impact revenue:
- Quality Measures: The GG OASIS items are used to calculate quality measures related to patient outcomes, such as functional improvement and prevention of adverse events.
- Performance Scoring: HHAs (Home Health Agencies) are scored based on their performance on these quality measures.
- Financial Incentives: HHAs with higher scores receive greater financial rewards under HHVBP.
In conclusion, the GG OASIS items play a vital role in determining revenue under HHVBP by influencing the calculation of quality measures. By understanding the impact of these factors, HHAs can tailor their care plans to optimize patient outcomes and improve their financial performance within the HHVBP program.
