March 19, 2008
Welcome to this issue of HFMA Wants You to Know, where you will find business solutions for caring organizations.
The introduction of Medicare severity-adjusted diagnosis-related groups (MS-DRGs) is a wake-up call for healthcare business leaders to work with physicians, nurses, and other clinicians to improve clinical documentation. “Under the new MS-DRGs, more than half of facilities with more than 100 cases will see their case mix index decrease if no coding and documentation changes are made,” writes Susan E. White, PhD, in the March issue of HFMA's The Business of Caring publication.
This special issue of The Business of Caring provides tactics, tools, and examples for working with clinicians to improve clinical documentation. The Business of Caring, which provides business essentials for nurse leaders, is copublished by HFMA and the American Organization of Nurse Executives. Here are just a few key take-ways from the issue:
Educate physicians on CC/MCC changes in their specialty areas. Under the new MS-DRGs, the lists of complications and comorbidities (CCs) and major complications and comorbidities (MCCs) changed dramatically, explains White, who is vice president of research and development for Cleverley + Associates. Many commonly used CCs (for example, atrial fibrillation) were removed. At the same time, more than 200 new, very specific CCs/MCCs were added.
Show physicians the link to improved quality data. Now that physician performance data is available online, physicians are eager to find ways to improve their quality ratings. “When you start showing the quality data to physicians, and they don’t look good because they didn’t document properly, they will change,” says Patrick Cawley, MD, executive medical director at Medical University of South Carolina (MUSC) in Charleston, S.C.
Make it easy to document. Develop templates, query forms, and educational pocket guides for physicians to make compliance easier, says Colleen Garry, BS, RN, manager of the clinical documentation improvement program at MUSC.
Help link your documentation specialists with clinical staff. The University of Michigan Health System assigned registered health information technicians (RHITs) to specific clinical service areas so they could expand their clinical knowledge and provide ongoing education to the clinicians, according to Gwendolyn Blackford, BS, RHIA, coding and health information manager.
Explain why documentation matters. It’s not just about improving revenue. Good documentation also improves patient care quality by ensuring that any other caregiver working with a patient has a complete picture of the care that has already been provided, writes Kathleen D. Sanford, RN, MA, DBA, FACHE, senior vice president and CNO of Catholic Health Initiatives.
Subscribe to The Business of Caring for yourself or for your nurse leaders to read this entire issue and get a year's worth of ideas to connect business principles with patient care.
You can learn the range of case mix index impact over the first six months of MS-DRG implementation from "MS-DRGs: Analysis of CMI Impact" on Thursday at ANI: The Healthcare Finance Conference, June 23-27 in Las Vegas.
And you can get additional advice on how to improve clinical documentation and coding in HFMA’s educational supplement Missed Opportunities. Your Strategy for Correct—and Complete—Charge Capture, sponsored by 3M Health Information Systems.
If you have questions or comments about "HFMA Wants You to Know," contact editor Robert Fromberg at rfromberg@hfma.org.
"HFMA Wants You to Know" ISSN: 1540-0697. Volume VII, Issue 6. Copyright 2008, Healthcare Financial Management Association. All rights reserved. March 19, 2008.