As 2025 looms on the horizon, the home health industry is buzzing with change. Between the rollout of OASIS-E1, updates to the PDGM and the value-based purchasing (VBP) overhaul, agencies are facing a dynamic environment that demands precision, adaptability and a healthy dose of strategic planning.
But amidst all the updates, one key player is stepping into the limelight: GG OASIS items. Their role in determining the Discharge Function Score Outcome Measure—a metric now commanding a whopping 20% of an agency’s Total Performance Score (TPS) in 2025—makes them the belle of the ball. Let’s break it all down, shall we?
OASIS-E1: The Next Evolution
The upcoming updates to OASIS-E1 bring refinements designed to align assessments with patient-centered care goals, streamline data collection and enhance interoperability across post-acute care settings. While some changes are minor, they demand a laser focus on staff training. For instance, updated guidance and refined response options are subtle but critical.
Why it matters: OASIS-E1 isn’t just about compliance; it’s about getting the right data to reflect the care you provide. Accurate assessments lead to better care plans, stronger outcomes and yes—higher VBP scores. Miss the mark here, and it’s like showing up to a potluck with stale crackers.
PDGM Adjustments: Tweaking the Formula
CMS has a knack for keeping us on our toes, and the PDGM updates for 2025 are no exception. With ongoing shifts in case-mix weights and functional scoring refinements, agencies must continually reassess their coding, therapy utilization and clinical groupings to stay ahead.
The key takeaway: PDGM isn’t a static formula—it’s a living, breathing framework that evolves. Agencies need to stay nimble, ensuring documentation supports coding accuracy and clinical group placement to optimize reimbursement.
VBP in 2025: The Stakes Are Higher
Now, VBP isn’t just a program—it’s the program driving how agencies approach outcomes, quality improvement and operational strategies. In 2025, the stakes climb higher as the Discharge Function Score Outcome Measure takes center stage. This measure reflects the change in patient function from admission to discharge, with GG items providing the backbone of the score.
Why you should care: With 20% of your VBP TPS tied to this outcome, any slip-ups in assessing, documenting or improving patient function could mean leaving dollars on the table—and no one likes an empty plate.
GG Items: The Undisputed MVP
Let’s talk GG items—the MVP of OASIS-E1. These gems assess patient mobility and self-care, like bed-to-chair transfers or ambulation. They’re now instrumental in calculating the Discharge Function Score, making their accuracy non-negotiable.
Why they matter:
- They’re worth their weight in VBP gold. Agencies must ensure clinicians score GG items accurately at admission and discharge, reflecting true patient progress.
- Training is critical. Missteps in scoring can distort data, undercutting outcomes and damaging your VBP performance.
- They spotlight your agency’s value. GG items highlight functional improvement, a cornerstone of value-based care.
Steps to Stay Ahead of the Curve
- Invest in Training: Clinicians need to master GG item scoring. From understanding definitions to avoiding common pitfalls, consistent training is your ticket to accuracy.
- Audit Early and Often: Implement internal and/or external audits to catch discrepancies and ensure your data tells the right story.
- Focus on Outcomes: Align care plans with measurable improvements in function. Every intervention should aim to boost those all-important GG scores.
- Leverage Data Analytics: Use analytics tools to track performance trends and identify gaps in care or documentation.
- Communicate Value to Staff: Help your team understand how their assessments directly impact the agency’s financial health—and patient care quality.
Take Action Now
2025 is knocking, and it’s bringing big changes to the home health stage. So, let’s roll up our sleeves, tune our focus and get ready to own the spotlight. After all, in the ever-evolving world of home health, adaptability isn’t just an advantage—it’s the key to thriving.
Let’s make it your agency’s best year yet. McBee can help you turn challenges into achievements! Join us on Dec. 4 to take your OASIS accuracy to the next level and improve clinical and financial outcomes!
About the Author
Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, VP of Education and Quality
Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, is the VP of Education & Quality at McBee, bringing over 35 years of expertise in home health and hospice. As a registered nurse and home care attorney, she specializes in regulatory compliance. Lisa has held various roles, from field nurse to executive, managing accreditation surveys, acquisitions, and regulatory crises. In 2004, she founded Selman-Holman & Associates, offering consulting, coding and OASIS review services. Lisa is a renowned educator, known for turning challenges into achievements. Joining McBee in 2021, she leads education initiatives at the Post-Acute Academy, providing courses for home health and hospice staff and executives, including clinical, regulatory and onboarding requirements.
About the Author
Michelle Horner, Manager of Clinical Consulting and Education
Michelle Horner, BSN, RN, HCS-O, HCS-D, HCS-H, COS-S is the Clinical Consulting and Education Manager for McBee. She has more than 30 years of experience in healthcare with an extensive background in critical care and home care. Michelle has been instrumental in the content creation for the McBee Post-Acute Academy. She currently specializes in Quality, Clinical, and Regulatory Consulting and Education. Michelle develops and provides custom on-site client education programs. She speaks regularly for various home care associations. Her expertise regularly appears in the Decision Health Diagnosis Coding Pro and she is a subject matter expert contributor for several Decision Health publications. Michelle currently serves on the AHCC’s Board of Medical Specialty Coding and Compliance Certification HCS-D and HCS-O Committees.
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