Black Book Survey: New Generation CDI Enhances Patient Care and Reduces Financial Risk

CDI is the key to better ICD-10 coding and reimbursement accuracy, but it's also vital for preparing organizations for population health.

Nearly a quarter of all U.S. hospitals now outsource some or all coding functions. Ninety-one percent of hospitals over 150 beds currently outsourcing their clinical documentation improvement (CDI) processes reported in Q3 to have realized significant increases (over 2.1M minimally) in appropriate revenue and proper reimbursements. CDI programs have been heavily implemented in this past year after ICD-10 transition, according to the latest Black Book survey of 2,920 health leaders.

“Because of this increased patient engagement, the need for proper clinical documentation improvement driving quality outcome scores has never been more essential,” says Doug Brown, managing partner of Black Book. “At the same time, the shift in care settings challenges financial leaders who are managing a far more complex enigma centered on optimizing the revenue cycle and reimbursements.”

93% of hospital and physician financial executives state they are actively seeking ways to link care with analytics and outcomes to support the consumerism of healthcare and shift to value-based payments through vendor solutions.

“CDI is a key step in dramatically improving operational efficiency in healthcare organizations,” Brown says. “Failing to address flaws in documentation processes has resulted in higher incidences of errors, financial losses and diminished patient care, and struggling hospitals will not survive on that old path.”

CDI, delayed as a high priority prior to ICD-10, has risen to the top of 2019 budget priorities, whether outsourced end-to-end coding or purchasing coding software solutions by 84% of those late to adopt, according to the survey results.

An impressive 88% of hospitals confirm documented quality improvements and increases in case mix index within six months of CDI implementation. The survey of hospital technology, financial and physician leaders found coding and clinical documentation improvements are now imperative.

Currently, 65% of hospitals over 200 beds surveyed now outsource CDI audit, review and programming, increased from 24% in 2015.

"CDI solutions are the critical link in ensuring full and timelier reimbursements from insurers and payers, as well as avoiding costly penalties for non-compliance,” Brown says. “This is why hospital chief financial officers have become the greatest advocates for outsourced end-to-end coding.”

89% of hospital financial officers claim that the biggest motivator for adopting additional CDI situations is to provide improvements in case mix index, resulting in increased revenues and the best possible utilization of high-value specialists.

A replacement market of pre-ICD-10 CDI and coding solutions and services is also trending, according to current users. 35% of those hospitals and physician groups presently outsourcing CDI and coding are contemplating a switch to a second- or third-generation CDI vendor as physician acquisitions and EHR replacement go-lives have threatened the sustainability or effectiveness of their current CDI programming, including both software and service.

90% of hospitals still not executing a positive impact CDI strategy and/or those using an less-than-effective coding results plan on partnering with a CDI vendor to assist them with the post ICD-10 fallout.

“EHRs are certainly playing a role in the industry-wide movement to increase clinician collaboration and communications,” said Brown. “Half of acute-care respondents in the 2016 Black Book survey were not confident that their EHRs effectively captured the patient data to meet developing clinical documentation needs for population health and big data initiatives, which has improved to a current confidence level of 70%.”

About Black Book

Black Book™, its founders, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the surveys it conducts. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges, consultation requirements, and/or vendor collaboration as Black Book polls vendors’ clients.

Since 2000, Black Book™ has polled the vendor satisfaction across over 30 industries in the software/technology and managed services sectors around the globe. In 2009, Black Book began polling the client experience of now more than 606,000 healthcare software and services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowd-sourced surveying to IT and health records professionals, physician practice administrators, nurses, financial leaders, executives and hospital information technology managers. For methodology, auditing, resources, comprehensive research and CDI, coding and medical transcription outsourcing ranking data, see: http://www.blackbookmarketresearch.com.

Source: Black Book Research


Categories: Healthcare and Medical Informatics, Physicians

Tags: 3M, AHIMA, CDI, Clinical Documentation Improvement, Coding, Medical Records, Nuance, Optum360


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