Improvement in Management of Oral Medications

The measure uses OASIS item M2020, Management of Oral Medications. CMS compares the response recorded at start or resumption of care with the response recorded at discharge. An episode counts in the numerator when the discharge response shows less impairment than the baseline. The denominator is every quality episode ending in a discharge during the reporting period, minus the exclusions below. CMS risk-adjusts the result with a model built for this measure.

This measure has one exclusion the other functional measures do not: episodes that began with no oral medications prescribed. Patients who could already take their oral medications correctly without assistance or supervision at start or resumption of care are excluded, and so are nonresponsive patients. Episodes that end with an inpatient facility transfer, death, or discharge to home hospice are excluded; the hospice rule applies to episodes ending on or after January 1, 2023. Generic exclusions remove patients who do not need an OASIS, such as patients under 18 and single-visit episodes.

Oral medications has been an HHVBP measure since the model's first performance year, CY 2023. Every M2020 answer recorded at start of care and discharge since then has counted toward your HHVBP score as well as your stars.

Improvement in management of oral medications is posted on Care Compare and is one of the seven measures in the Quality of Patient Care Star Rating. It is still in the expanded HHVBP model's OASIS-based category for CY 2026. CY 2023 performance set the first HHVBP payment adjustments in CY 2025, within a range of minus 5% to plus 5%; the dollar effect scales with your Medicare fee-for-service revenue.