Clinical documentation improvement and coding are becoming more crucial for hospitals as they strive to remain sustainable in a value-based care world.
Without accuracy in these areas, organizations are unable to receive proper reimbursement, which in turn can affect the bottom line.
Here, Marisa MacClary, co-founder and CEO of Artifact Health, which provides a mobile app for physicians to respond to CDI and coding queries, shares four CDI and coding trends for hospitals to watch in 2018.
1. CDI profession changes due to technology. New technologies continue to permeate the healthcare industry, with some focused on the CDI physician query process used to ensure proper documentation of care. These technologies, such as those provided by Artifact, aim to streamline the query process and eliminate the time CDI specialists spend following up with physicians to get queries answered. Ms. MacClary believes a number of hospitals can benefit from the technologies, particularly facilities without enough CDI specialists. The more time CDI specialists save by cutting laborious query follow-ups, the more time they have to review additional cases, according to Ms. MacClary.
2. Physician burnout. Physicians are increasingly reporting burnout. According to Medscape's most recent annual survey, 51 percent of physicians reported experiencing frequent or constant feelings of burnout last year, compared to 40 percent in 2013. Given this trend, the healthcare industry is taking steps to reduce physician burnout. Just last year, the Stanford University School of Medicine in collaboration with the American Medical Association and Rochester, Minn.-based Mayo Clinic hosted the first-ever American Conference on Physician Health. According to the AMA, the conference specifically focused on how organizations can help combat physician burnout and promote physician well-being.
Artifact contends one way hospitals can lessen the burden on physicians is by using technology that helps them complete coding queries faster. "So I think we're going to see a lot of changes … as physicians' voices are getting louder and demanding technology that makes it easier for them [to do their jobs] and not more difficult," said Ms. MacClary.
3. Value-based purchasing. The Medicare Hospital Value-Based Purchasing Program is intended to encourage hospitals to provide high-quality care more efficiently by adjusting payments to hospitals based on the quality of care they provide. The program adjusts Medicare payments to hospitals under CMS' Inpatient Prospective Payment System.
Ms. MacClary said it is crucial for hospitals to accurately code claims and ensure physician documentation supports care provided to receive proper reimbursement. She believes hospitals will increasingly focus on coding accuracy and physician documentation.
4. Consumer access to quality reporting entities. More than ever, consumers are able to research hospitals' quality scores via a number of reporting entities, such as Healthgrades and Leapfrog. Since these entities gather information based on a hospital's coded data, lack of coding accuracy could result in a lower quality ranking, Ms. MacClary said. She believes hospitals are becoming more aware of this as quality reporting entities become more prevalent. This is "certainly a big trend for hospitals to make sure their reputation is in line with the quality of services they provide," she said.
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