The 2019 ACDIS Outpatient CDI Symposium, hosted at the Hyatt Regency in Austin, Texas, was just right. A good balance of sessions that covered clinical, financial, analytical, regulatory, and quality requirements for CDI teams and a strong emphasis on best practices required to create a successful program.

Over two full days, organizations that have already implemented an Outpatient CDI (OPCDI) program shared many case studies and real-world examples of proven design and deployment strategies.

Taking the “lessons learned” approach a step further, several presenters and poster presentations compared successful program plans and decisions to those that did not provide the expected results, along with valuable details about changes they made to overcome unforeseen obstacles.

 

Creating an Outpatient CDI Program: Where to Start

The conference focused exclusively on the many ways healthcare providers can continue to meet their clinical documentation integrity objectives by broadening their scope of services to support patients served outside of the inpatient environment. CDI leaders highlighted their real-life experiences as they expand services to:

  • Emergency Departments,
  • Observation Patients,
  • Outpatient Services,
  • Physician Offices and Clinics,
  • Home Health, and more.

 

Approximately one-fourth of all US-based hospitals have reportedly started an outpatient CDI program in their organization. Determining where and how to begin was one of many hot topics during the event, and several session presenters provided useful guidance.  Typically, CDI leadership begins by identifying areas and service lines where they may have the most significant impact in terms of patient care and revenue cycle. They usually start with a focus on departments that have a high-volume of outpatient services or represent high-dollar services.

Program Analysis and Performance Tracking

Several of the presenters discussed methods for tracking the success of an OPCDI program. Among the creative ways the healthcare organizations have found and developed to analyze their program progress are:

  • Leveraging an abundance of data offered by CMS, which supports benchmarking and provides comparison analytics (and it is free!),
  • Using the data elements accessible via their electronic medical records (EMRs) and other technology platforms,
  • Engaging with their in-house analytics team to create standardized data capture and reporting (or engaging with a vendor that can assist with this step), and
  • Regularly comparing their outpatient and physicians/specialties to the CMS and internal data to identify best-practices, areas for improvement, and trending.

Where to find CDI-related data

 

As the US healthcare industry moves to more managed care reimbursement models, the need for accurate clinical data capture to support the best patient outcomes and meet advancing reporting requirements – such as hierarchical condition categories (HCCs) – will continue to grow. It is imperative that healthcare executives and revenue cycle leaders continue to work through case management scenarios and implement programs that ensure their patients are receiving the best care possible.  A robust OPCDI program is a critical component of that process.

 

 

Explore OPCDI and More at ACDIS 2020

ACDIS 12th Annual Conference on May 20-23 at the Gaylord Palms Resort & Convention Center in Orlando, Florida. Beyond Hospital Walls: CDI Expansion Across The Health System headlines the pre-conference workshop lineup. In addition, you will find workshops on The Physician Advisor’s Role In CDI and CDI Management Essentials. Session tracks during the main conference will include:

  • Clinical & Coding
  • Management & Professional Development
  • Quality & Regulatory
  • Innovation & Expansion
  • Idea Laboratory
  • Outpatient & Pediatric

A robust healthcare revenue cycle – which supports both appropriate, timely payments and minimal denials – is fueled by two essential elements: detailed, complete clinical information and accurate analysis and medical coding.

EXTEND Resources helps healthcare clients create and leverage high-quality clinical information to drive accurate coding, clean claims, and fewer denials through cost-effective clinical documentation integrity, medical coding, and coding audit services  Click here to learn more.