Joanne Webb of J.A. Thomas & Associates, a Nuance company attending the marcus evans National Healthcare CFO Summit Spring 2015 and the National Healthcare CXO Summit Spring 2015, on improving clinical documentation.
NEW YORK, NY, May 5, 2015 - (ACN Newswire) - "Clinical Documentation Improvement (CDI) has become critical to hospital performance, not just for financial reasons, but for making sure they are able to capture quality outcomes with value-based purchasing," says Joanne Webb, SVP Healthcare, J.A. Thomas & Associates, a Nuance company. "Hospital CFOs and CEOs must realize that good quality clinical documentation drives financial outcomes and performance metrics," she advises.
J.A. Thomas & Associates, a Nuance company, is attending the marcus evans National Healthcare CFO Summit Spring 2015 and the National Healthcare CXO Summit Spring 2015, in Palm Beach, Florida, May 17-19.
- After clinical data is captured, why should hospitals improve the quality of the information? How?
Hospitals should look at what physicians have dictated or transcribed, and ask: How does it appropriately reflect how the patient was treated? Does it have the level of specificity that is needed? Are there additional diagnoses that need to be documented, so we can capture them at coding and billing? It is important that the documentation says everything it needs to say about the patient.
With electronic health records, information is now very fragmented. Several years ago, hospitals would get paid based on fee-for-service. Now hospitals are held accountable for quality of care and quality has gradually impacted payment methodology. Thus, information from the physician has to support all of the quality metrics, and show the severity of the illness and what conditions were present on admission, so the hospital does not get unwarranted penalties for existing conditions.
- What will ICD-10 change? How should hospitals prepare?
Many healthcare CFOs and CEOs see ICD-10 as a coding problem, but before that, it is actually a documentation problem, as there are certain elements that a physician needs to document for ICD-10 specificity.
Considering ICD-10 as part of the documentation improvement program is critical. Computer assisted coding (CAC) applications were brought to market to help hospitals manage the increased level of coding that would be required. Without complete, clinical and compliant documentation, coding will not be accurate, regardless if done by a coder or a CAC application. Coders may be retrospectively trying to clean-up the documentation further holding up billing and irritating physicians.
- What makes the biggest impact on the bottom line? What are the primary drivers of revenue?
Hospitals are getting audited by entities that are in many cases incentivized to find gaps and errors in documentation and coding. By improving the quality of documentation, some of the audit risk would get mitigated.
We can absolutely drive additional payment through better quality documentation. Most of the time patients are sicker than previously recorded, so the hospital can get paid appropriately for the cost of care and length of stay if documentation supports severity of illness.
In addition with value-based purchasing, hospitals have the potential to secure additional revenue by having good outcomes data and demonstrating quality of care.
The healthcare market is very competitive and many organizations are consolidating. It is very important that every hospital in a system has the same quality of documentation, so the performance of one does not drag down the performance of all.
Just because a hospital has a CDI program it does not mean it is performing well. Now is a good time for executives to reevaluate their programs and make sure they are functioning at a high level to support ICD-10 implementation and key performance metrics.
For more information please send an email to press@marcusevanscy.com or visit the event websites below:
National Healthcare CFO Summit Spring 2015 www.nhcfosummit.com/JoanneWebb2Interview
National Healthcare CXO Summit Spring 2015www.nhcxosummit.com/JoanneWebb2_Interview
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About J.A. Thomas & Associates
For more than two decades, J.A Thomas and Associates (JATA) has provided our clients with a fully managed, end-to-end clinical documentation improvement (CDI) program that touches all critical aspects of an institution's clinical documentation process. The firm's Compliant Documentation Management Program(R)(CDMP(R)) has produced CMI improvement of 4-8%, on average, reimbursement appropriate to level of care provided to patients, and physician engagement and buy-in, all with comprehensive program maintenance, structured compliance support and an infrastructure to sustain positive results.
JATA CDI solutions - powered by the innovative technology of Nuance Communications - streamline clinical documentation efforts and deliver richer, more actionable information. Nuance is the largest clinical documentation provider in the U.S. and helps more than 500,000 physicians and 10,000 healthcare facilities worldwide drive smart, efficient decisions across the continuum of healthcare. www.nuance.com.
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