Risk-adjustment, clinical documentation, medical coding, ,

How Clinical Documentation Improvement Provides a Foundation for Value Based Care

    posted on          2018-03-28 12:53:06, USA

Posted by: Michael Arrigo

Please see the article in PDF form or the link.

Opening paragraph:

Clinical documentation improvement (CDI) initiatives are underway in healthcare organizations across the country, with the aims of improving care and reducing costs. Are they working? At least one such initiative, at Baptist Health South Florida, is providing solid return on investment.

“Like all health systems, we are trying to do things better, and the better we document and code, the better we may be reimbursed, but what we learned over the years is, the best way to protect ourselves is to have the most accurate documentation,” says Ralph Lawson, executive vice president and corporate CFO of Baptist Health South Florida, which has 13,000 employees working in six hospital campuses and satellite locations. “We don’t want up-coding or down-coding. We want the best clinical documentation.”

Baptist’s CDI initiative consists of two elements: the use of tools that facilitate documentation in realtime, and the employment of physicians as clinical documentation specialists who ensure documentation is being done correctly and help train caregivers in the documentation.