How OASIS-E1 Training Can Improve Success in Home Health Value-Based Purchasing

As the home health landscape rapidly evolves, the importance of precise clinical documentation and performance-based care delivery is more critical than ever. The introduction of the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023 has significantly shifted the focus from volume to value. At the heart of this transformation lies a tool that has long been central to home health documentation: the Outcome and Assessment Information Set (OASIS).

With the most recent update, OASIS-E1, going into effect on January 1, 2025, agencies and clinicians are now required to adapt to new elements that not only impact compliance but also play a pivotal role in HHVBP scoring. Investing in OASIS-E1 training isn’t just about keeping up—it’s about driving better patient outcomes and maximizing reimbursement in a competitive, value-driven environment.

In this article, we’ll explore how OASIS-E1 training empowers home health professionals to thrive under HHVBP, and why it should be a top priority for every agency in 2025.

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Understanding the Link Between OASIS and HHVBP

The OASIS data set is the foundation for multiple CMS initiatives, including HHVBP, Star Ratings, and PDGM (Patient-Driven Groupings Model). It’s more than just documentation—OASIS is the lens through which CMS evaluates agency performance, risk adjusts outcomes, and compares providers nationally.

Under HHVBP, an agency’s total performance score (TPS) is determined by three main components:

1. OASIS-based measures

2. Claims-based measures

3. HHCAHPS survey results

Several OASIS items directly impact outcome measures, such as:

• Improvement in ambulation

• Improvement in self-care

• Discharge to the community

• Rehospitalization rates

Accuracy in OASIS documentation directly affects how well an agency performs on these measures. Inaccurate assessments can lead to incorrect baselines, poor outcome tracking, and ultimately lower TPS scores—resulting in financial penalties rather than bonuses.

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What’s New in OASIS-E1?

While the overall structure of OASIS remains intact, the E1 version introduces changes and removals that are directly relevant to value-based care. Here are key updates:

• Removal of certain items: Items like M0110 (Episode Timing) and M2200 (Therapy Need) have been deleted due to their obsolescence under PDGM and value-based models.

• Addition of cognitive, social determinants, and transfer of health information items: These changes align with CMS’s broader push toward whole-person care.

• Standardization across post-acute settings: E1 supports interoperability and cross-setting comparisons, which is essential for care coordination and transitions.

• Greater emphasis on functional and outcome-related data: With more weight on mobility, self-care, and discharge planning, these areas are central to VBP scoring.

Each of these changes means that clinicians need to be retrained not just on what’s new or removed, but how to assess and document these elements accurately and consistently.

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Why OASIS-E1 Training is Essential for HHVBP Success

Here are the key ways that OASIS-E1 training supports success under Home Health Value-Based Purchasing:

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1. Improves Data Accuracy and Integrity

Training ensures that clinicians understand the intent behind each item, the definitions, and the correct scoring methodology. Inaccuracies in OASIS data can skew risk adjustment and falsely indicate poor outcomes. OASIS-E1 includes new or updated items that many clinicians may not be familiar with, such as:

• D0150 (Patient Mood Interview)

• B1300 (Health Literacy)

• A2121/A2123 (Transfer of Health Information)

Properly completing these sections requires knowledge of interviewing techniques, coding guidelines, and CMS intent—all covered in robust training programs.

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2. Optimizes Functional Outcome Scoring

HHVBP rewards agencies for functional improvement in areas like grooming, dressing, toileting, and ambulation. These are directly tied to OASIS items (GG0100-GG0170 and M1800 series). A clinician’s ability to accurately assess baseline function and detect progress over time hinges on training.

Example: Misunderstanding the difference between “supervision” and “setup assistance” in functional mobility can drastically affect improvement scoring.

Trained clinicians are better equipped to:

• Set realistic care goals

• Identify improvement opportunities

• Prevent underreporting or overreporting of patient ability

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3. Supports Risk Adjustment and Fair Benchmarking

HHVBP compares agencies based on outcomes adjusted for patient characteristics like:

• Cognitive status

• Comorbidities

• Socioeconomic factors

OASIS-E1 introduces new items that capture social determinants of health (SDOH) and cognitive function. Correct completion of these items is vital for proper risk stratification. Without training, agencies risk underreporting complexity, making their outcomes appear worse than they are.

A trained clinician understands how to:

• Identify depression using the PHQ-2 tool (D0150)

• Document medication reconciliation accuracy

• Capture transportation or health literacy challenges

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4. Reduces Hospital Readmissions

Unplanned hospitalizations are a major negative indicator in HHVBP. Training helps clinicians better assess:

• Red flags during the start of care

• Early interventions for worsening symptoms

• Need for physician communication

OASIS-E1 items like J0510 (Pain Interference) and N0415 (High-Risk Medication Review) help guide proactive care planning. Training ensures clinicians understand how to document these assessments clearly and defensibly, which is essential when readmission data is reviewed or challenged.

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5. Enhances Interdisciplinary Collaboration

OASIS-E1 reinforces the importance of comprehensive, team-based care. With many of the new items requiring insights from nursing, therapy, and social work, a unified training approach creates alignment.

For example:

• GG items are best addressed through collaboration between nursing and therapy.

• Cognitive screenings may involve both nursing and the medical social worker.

• Health literacy assessments may require coordination with case management.

Cross-disciplinary OASIS-E1 training ensures that everyone speaks the same language, leading to consistent scoring, better outcomes, and stronger VBP performance.

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6. Supports Better Discharge Planning

Discharge outcomes play a pivotal role in HHVBP scoring, particularly:

• Discharge to community

• Improvement in self-care

• Improvement in mobility

Training helps clinicians understand how to document a patient’s true baseline at SOC and how to show progress over time. It also clarifies when and how to update care plans, document refusals, or mark a patient as no longer eligible for improvement goals.

Proper discharge documentation can prevent unnecessary audits or data discrepancies.

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The Financial Impact of Getting It Right

HHVBP comes with real financial consequences. Agencies can gain or lose up to 5% of their total Medicare reimbursement depending on their performance relative to peers. Inaccurate OASIS documentation can lead to:

• Lost revenue from missed bonuses

• Penalty payments due to low TPS scores

• Lower Star Ratings, affecting referrals

• Ineffective care plans, leading to poor outcomes

Investing in OASIS-E1 training is far more cost-effective than dealing with the consequences of avoidable documentation errors.

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What Effective OASIS-E1 Training Looks Like

Not all training programs are created equal. To truly impact HHVBP performance, a training program should be:

• Interactive – Not just slide decks, but case-based learning and real scenarios.

• Updated for 2025 – Fully aligned with the latest CMS changes in OASIS-E1.

• Role-specific – Tailored content for nurses, therapists, QA reviewers, and administrators.

• Ongoing – Includes refresher courses, audits, and feedback loops.

• Measurable – Offers assessments or evaluations to verify comprehension.

Some top providers of OASIS-E1 training include:

• DecisionHealth

• McBee Associates

• Axxess

• ElevatingHome / VNAA

• Relias

These programs often come with CEUs and can be integrated into onboarding for new hires.

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Final Thoughts

As HHVBP continues to drive transformation in home health, the margin for documentation error grows slimmer. OASIS-E1 is more than a compliance update—it is the foundation of how care quality, patient outcomes, and agency performance are measured and rewarded.

Clinicians who are trained in OASIS-E1 not only improve their own confidence and accuracy, but also contribute to a stronger, more competitive agency that thrives under value-based care.

In 2025 and beyond, agencies that prioritize high-quality, comprehensive OASIS-E1 training will see the greatest return—not just in revenue, but in patient satisfaction, reduced hospitalizations, and long-term sustainability.

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Key Takeaways

• OASIS-E1 changes affect multiple HHVBP outcome measures.

• Training improves accuracy, risk adjustment, and functional scoring.

• Proper documentation reduces penalties and maximizes VBP bonuses.

• Interdisciplinary training ensures consistency across the care team.

• Agencies that invest in training will have a competitive edge in 2025.