The authors determined whether a home health agency could use Outcome Assessment and Information Set (OASIS) items and the Outcome-Based Quality Improvement (OBQI) model to enhance outcomes for health maintenance organization (HMO) patients. After an initial baseline period and four quarters of quality improvement activities, Improvement and Stabilization scores showed few significant changes. When the results were reviewed, investigators considered both the HMO authorization patterns and challenges encountered in using the OASIS-OBQI paradigm.