A strategy across two facilities increases number of patient reviews while improving operability and physician response rate.
It’s simple. Better documentation means more accurate coding. More accurate coding can lead to higher reimbursements. For CoxHealth in Springfield, Mo., improving its physician documentation played a big part in capturing $775,000 in CMS prospective payments.
The Cerner ITWorks Client is a pilot for Cerner’s Embedded Clinical Documentation Improvement (CDI) solution. In 2015, 11 CoxHealth CDI nurses and 500 staff physicians began using the strategy across two facilities.
While physician documentation is nothing new, the solution makes it easier.
“The embedded tool has given us more satisfaction and ease of operability,” explained Angie Curry, BSN, RN, CCDS, and Corporate CDI Manager at CoxHealth.
CoxHealth care teams use the Embedded CDI™ solution within Cerner Millennium® to see the working MS Diagnosis Related Group. Case Mix Index (CMI) is a value assigned to a Diagnosis Related Group of patients and helps determine the allocation of resources to treat the patients in that group.
CoxHealth improved its CMI at its Springfield location from 1.86 to 1.8715 in a year. With its hospital base rate of $5,570, that equates to an additional $559,072 in prospective payments.
For the Branson medical center, its CMI increased from 1.553 to 1.569. With a hospital base rate of $5,387, this leads to $216,258 in potential revenue for the facility.
The two CoxHealth facilities using Embedded CDI totaled an additional $775,330.
“Before, physicians thought [CDI] was a way to communicate to their other coworkers,” she said. “They now understand it’s billing, Centers for Medicare & Medicaid Services, publicly-reported data — all of these things are coming to the forefront for the physician.”
The two facilities also increased the number of patient reviews performed by a clinical documentation specialist by 6 percent at one facility and 17 percent at the other. CoxHealth also increased the physician response rate to an automated query by 99 percent at both facilities.
Those reviews can lead to better documentation, better coding, and in turn, higher revenue.
“That’s given us a huge opportunity for education with the providers on how coding and documentation works," said Curry.
And, because the solution is embedded, it’s easier for nurses and physicians to use – and document.
“Rather than logging in and out of a couple different programs, it’s all set in with one username and password,” said Curry. “Basically just a better workflow for CDI.”
“It’s an exciting time to have all of that information located in one record, and that’s the biggest benefit that Cerner has brought to us.”