ORYX is coming, but there's no need to rush
JCAHO tries to alleviate worries on timing, costs
When Homecare Quality Management interviewed home care organizations for last month's story on ORYX (see HQM, May 1998, p. 73), most of those contacted reported they had done little or nothing to prepare for the coming of the new outcomes measurement system. Indeed, many expressed concern over costs and over the increasing number of requirements and regulations that home care companies face.
But according to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), there is no need to panic. "Organizations have until the end of the year to select a system, and until the third quarter of 1999 to submit data," says Maryann Popovich, RN, MPH, director of home care accreditation services at the commission. "And we aren't looking for a signed contract on a system," she adds, "just that you have made a choice."
Popovich, who has been crisscrossing the country conducting seminars on ORYX, says she, too, has fielded questions and concerns from companies who are worried that they are behind schedule. "All we want is for you to be exploring systems now. We don't really recommend you choose one yet, because for Medicare-certified agencies, OASIS requirements are not expected out before June. And that's a best-case scenario."
Medicare-certified agencies need to make sure OASIS data elements are included in the systems they're evaluating, she says.
Popovich says most agencies should really just be pulling their staff together to start planning for ORYX. "Talk to your staff and figure out what are the items your particular organization should be measuring. You don't have to pick the two items yet, but be talking about it."
Cost concerns run high
The commission's own material on ORYX (available at its Web site at www.jcaho.org) states that the cost for implementing ORYX averages about $10,000. Some organizations HQM spoke with last month said that figure was a huge amount for them, particularly when reimbursements are declining and agencies are being squeezed financially. Popovich is hearing the same kinds of questions at her seminars, and she alleviates the concern by noting that while the average cost of the 53 reviewed systems is $10,000, there are some that are much cheaper - as low as $500.
"Not every system requires electronic transmission," she says. "You can do it manually." But, she notes, there will still be costs - even if it is just copying and mailing reports. "But you can't view this as an extra, unnecessary expense," she says. "We see this as critical. And in the long run, you may even find inefficiencies and problems whose correction will save you money."
For instance, if you find through your data collection that you have outliers in diabetic care, and you see that those outliers all suffer from an additional condition - such as congestive heart failure - you can use that information to approach your payers to provide for more visits with such patients.
Popovich says she's also getting a lot of questions about how relevant the measures will be for other segments of home care. That evaluation will be finished soon, she says. For now, home care and hospice look complete. "We hope that if someone finds something that we are not addressing, they will let us know. For instance, if maternity or pediatric home care find a measure that just doesn't apply to them, call us."
There are still seminars on ORYX available. They include information on ORYX, how to evaluate and choose a system, and question-and-answer sessions. They are: June 4 in Washington, DC; June 11 in East Elmhurst, NY; June 26 in Memphis, TN; and July 9 in Rosemont, IL. The cost is $195 per person. Further information is available through the Joint Commission.
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