Medicare Home Health Social Workers’ Views on New OASIS Questions on Housing,Food,Utilities,and Transportation

Abstract

In its 2025 final payment rule for Medicare Home Health published November 7, 2024, the Centers for Medicare and Medicaid Services added 5 questions to the outcome and Assessment Information Set (OASIS) needing to be addressed: 4 new (i.e., 1 on living situation; 2 on food insecurity; 1 on utilities) and 1 that revised transportation. The rule states that the changes are responsive to issues in the social determinants of health category and take effect with the calendar year 2027 Home Health Quality Reporting Program. A literature review indicates no studies on the potential impact of these OASIS revisions on Medicare home health social work services, the service for social needs. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of 31 Medicare home health social workers between January 6, 2025, and February 9, 2025, in the New York City metropolitan area. Three themes emerged, including: social workers believe the new requirements (1) are overdue, needed, and provide the potential to increase services to deal with many unmet social needs; (2) Medicare continues to neglect the expansion of social work coverage and payment to home health agencies for supplemental social needs necessary to make the new requirements effective for Medicare home health patients; and (3) Medicare still does not mandate that any Social Determinants of Health need detected through the new OASIS requirements must receive follow-up care with appropriate, covered interventions and the OASIS questions do not affect scoring for episode payment.