CDI & DRG

CDI & DRG Implementation

Clinical documentation initiatives that incorporate clinicians within revenue cycle operations can help hospitals better prepare for population health management.

Powerful analytics tools will fail to generate actionable insights into a hospital's patient population if its raw clinical data is incomplete or flawed. Ensuring comprehensive and accurate clinical documentation is a strategic priority for all hospitals hoping to thrive under population health management models. As health systems continue to assume a greater volume of risk-based payments, clinical documentation improvement will begin to shift from a revenue-enhancement mechanism to a function organized around capturing quality and managing high-risk patients. Progressive health systems are establishing CDI programs that support care management and standardize documentation patterns to capture payments tied to achieving certain quality thresholds. More comprehensive and accurate clinical documentation shows treatment was administered according to medical necessity

Effective approach for
Clinical Documentation
Improvement

Analysis and interpretation:

Before investing in CDI programs, hospitals should take time to analyze current clinical documentation, coding, and revenue cycle performance. This can help hospital leaders target cash leakage, problematic quality reporting or insufficient clinical documentation.

Assemble a CDI team:

Effective clinical documentation improvement programs employ a variety of specialists and staff members to influence meaningful change.

CDI specialists
Physician champion
Cross-functional team

Choose a model:

Different CDI models target different parts of a hospital's documentation life cycle. Hospitals can incorporate multiple models within their CDI initiatives depending on those areas that merit attention. Hospitals should develop and establish CDI programs that focus on health information management and coding, case management and continuity of care and quality reporting issues.

Establish employee training programs:

CDI leaders and staff members should develop education programs to introduce hospital employees to best practices in documentation and coding. Physician training programs, for instance, should include mandatory CDI orientation for new clinical staff, encourage ICD-10 coding knowledge and share data on problematic diagnosis-related groups