To support continuous improvement of clinical, financial and operational outcomes, clinical documentation improvement (CDI) teams need data-driven insights that allow them to address low-hanging fruit, as well as to identify gaps where performance improvement is required.
During an April webinar hosted by Becker's Hospital Review and sponsored by MedeAnalytics, two leaders from Ardent Health Services in Nashville, Tenn. — Trevor Snow, vice president of health informatics, and Adrienne Younger, AVP of clinical documentation integrity — joined Brenda Turner, director of product consulting at MedeAnalytics, to discuss how Ardent is using self-service analytics to drive improvements for case mix index, comorbid condition/major comorbid condition capture rates and length of stay.
Five takeaways:
1. Although many CDI teams rely on PEPPER reports, the data lacks detailed insights. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a quarterly report with Medicare data for discharges in 27 service areas that are vulnerable to improper payments. Each PEPPER report contains information for the most recent 12 federal fiscal quarters, according to presenters. Although PEPPER reports are valuable for CDI teams, they have several weaknesses. "PEPPER reports don't provide visibility into specific claims at risk, nor do they offer guidance on how to build action plans to address outlier target areas that are subject to audit," Ms. Turner said. "This limits the CDI and compliance teams' ability to proactively address audit and denial risks."
2. Combining PEPPER reports with analytic tools provides in-depth analysis CDI teams need. Augmenting PEPPER information with analytics enables CDI teams to identify specific claims at risk based on outlier target areas and to identify physicians driving trends. As a result, CDI teams can create informed physician and coder training. They can also validate improvement efforts by measuring reductions in readmissions, short stays, audits and denials.
3. MedeAnalytics has changed the game for Ardent's CDI team. Ardent Health Services implemented MedeAnalytics in 2017. Prior to then, CDI reports were not standardized across facilities. The organization lacked detailed insights on how to improve performance by facility or service line, and the CDI team was unable to identify the cause of certain trends.
"MedeAnalytics allows us to look at our core metrics across the company and break them down by market and facility," Mr. Snow said. "We quickly earned the trust of our C-suite by presenting data that is valuable and actionable. MedeAnalytics also enables us to have non-emotional, data-based conversations with physicians."
4. Thanks to analytics, Ardent's CDI staff works strategically to address the greatest opportunity areas. "The 'aha' moment for us was realizing we could identify the service lines that bring the most volume to facilities and focus our efforts there," Ms. Younger said. "We have 30 hospitals and the top five DRGs vary by hospital. We assign CDI staff to the biggest opportunities for each facility as defined by volume and length of stay."
5. MedeAnalytics has also played a central role in the organization's growth plans. Each time Ardent Health Services acquires a new facility or system, it turns to MedeAnalytics. "We start looking at improvement opportunities as quickly as possible. MedeAnalytics has become a go-to tool, and it's given us a leg up earlier than in the past," Mr. Snow said.
The tangible results and measurable value speak volumes about the impact of self-service analytics from MedeAnalytics at Ardent Health Services. Ardent saw an 8.6% reduction in Length of Stay (LOS) for 2 DRGs in 2019-21, a 13% increase in case mix index (CMI) from 2018-21, a 12% improvement in CC/MCC capture rates, and a 95% reduction in report turn-around-times (TAT).
Mr. Snow and Ms. Younger agreed analytics is a team sport. "The people part of analytics is very important," Mr. Snow said. "It's something we all had to embrace from the CDI team to coding and all the way up to the C-suite. Success requires people, software and processes. A great partner like MedeAnalytics makes life easier."
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