CASPER is an acronym for Certification And Survey Provider Enhanced Reports. These are reports that are compiled using your submitted OASIS data to demonstrate your agency’s performance. Current metrics are benchmarked against a prior period and the national rate. All home health agencies are required to submit OASIS data for any home health patient who has Medicare or Medicaid, is over the age of 18 and is receiving services unrelated to pre or postnatal conditions.
How do I start?
You access your CASPER report from the Quality Improvement Evaluation System (QIES) application website for your state. This is the same website you use for OASIS submissions. Sign in using your username and password and then click OASIS. If your agency does not have a username and password, contact the CMSNet Helpdesk at (888) 238-2122 or go to the CMSNet Information website.
After signing in, the CASPER Reporting link gives you access to reports. This is the same link that you use to receive Final Validation reports for your OASIS submissions. You will need a separate User ID and Password to enter this area of reporting. If you don’t know it, click on the Unable to login link for assistance.
After signing in, you will be at the CASPER Home Page. To access your quality reports, you must compile them. Click on Reports then OASIS Quality Improvement on the left. You can select any individual report or find the Quality Improvement Package in the listed reports.
The Quality Improvement Package is a quick way to compile multiple reports for whatever period you designate. Check the reports you want to see, we recommend the Process Measures Report, Agency Patient-Related Characteristics (Case Mix) Report, Risk Adjusted Outcome Report, Potentially Avoidable Event Risk Adjusted Report, and Potentially Avoidable Event Patient Listing Report. These reports are fairly easy to read and interpret.
The dates you put in will depend on what period you are evaluating. For example, if you want to look at your agency’s performance for February 2018 compared to February 2017, you would put in 02/2017 for Prior Begin Date and Prior End Date and 02/2018 for Current Begin Date and Current End Date. Claims begin and end dates apply to your Outcome Report where Claims Based Outcomes are calculated from claims based on your episode begin date. You can choose to have your data separated by branch, if applicable, by clicking the Report by Branch box. When you have entered all of your criteria, click Submit.
Depending on the amount of information you have requested, reports may take some time to process. When they are ready to view, they will be available in your My Inbox folder. Simply click on Folders at the top menu bar and click on My Inbox on the left. Click on the name of the report to open it. Once opened, you can hover at the bottom of your screen to find print and save icons. We recommend saving the files in date-specific folders so that you can retrieve your reports without having to log in and re-compile them. When you have saved and/or printed all of your files, be sure to delete them from your My Inbox folder so that you don’t get mixed up when processing new reports later.
Using reports for QAPI
Your Potentially Avoidable Event reports are a great place to start in developing a focus for your QAPI program. Potentially Avoidable Events used to be referred to as Sentinel Events or Adverse Events. They are significant changes in the patient’s clinical condition as demonstrated by emergent care or a general decline in patient health or function. Review the Patient Listing Report to identify patients who have had a potentially avoidable event.
Outcome reports are another terrific source of information for defining your QAPI focus. Many of the metrics listed on your agency’s Outcome report are also publically reported on Home Health Compare and contribute to agency star ratings. Identifying and improving areas of poor performance from this report could help to boost your agency’s marketability by demonstrating better performance than competitors in your area.
And don’t forget your Process Measures report. This report reflects your agency’s performance for each identified measure. The measures listed all tie into best practice guidelines for home health care. Poor performance in any of these measures could be a sign of incomplete clinical care planning or a lack of understanding of the OASIS M0 questions that tie to the process measure.
After you have identified the measures you will work on in your QAPI program, you will need to analyze charts and monitor performance to verify that your interventions are resulting in improvement. Don’t be afraid to try several things at once. Since CASPER reports are a few months behind real data, it’s a good idea to do periodic chart reviews to monitor whether interventions are effective. If you had identified problem employees or patient demographics in your initial data, focus your audits on those. Use CASPER reports to show general trends toward improvement or decline in your area of focus.
Remember, this is a process. There will probably never be one quick fix that will solve all of your issues. Trying new things, documenting the results, and learning from your mistakes is the true key to a successful QAPI program.
If you are looking for more information about OASIS and CASPER reporting, check out the QTSO OASIS User Guides & Training website. This website lists CMS OASIS Q&As, has the OASIS Submission User’s Guide and the CASPER Reporting User’s Manual. You can also check out the bottom of the CMS Home Health Quality Measures website for the Outcome-Based Quality Improvement (OBQI) Manual and the Outcome-Based Quality Monitoring (OBQM) Manual. Keep an eye out on our website for new articles coming soon about other aspects of a good QAPI program.