Nuance’s Clintegrity CDI generates $2.2 million gain in appropriate revenue and enables 11% improvement in Case Mix Index (CMI) for Valley Medical Center.
Nuance Communications, Inc. announced today that Valley Medical Center, part of the University of Washington Medical Center, has achieved higher levels of clinical excellence and gained additional revenue through proper reimbursements thanks to Nuance Clintegrity 360 solutions. Valley Medical has improved the quality of clinical information in its electronic health records (EHRs) and realized more than $2.2 million in appropriate reimbursement following the implementation of the Nuance Clinical Documentation Improvement (CDI) program developed by Nuance’s J.A. Thomas & Associates (JATA).
One year after implementing the Nuance CDI program, Valley Medical Center achieved rich clinical content and quality, earning the Distinguished Hospital Award for Clinical Excellence from Healthgrades. The organization surpassed its goal of better describing the complexity of their patients’ cases through physician documentation, increasing its Case Mix Index (CMI) by 11 percent.
“The benefit of obtaining better clinical information is that physicians and nurses can provide better care to patients,” says Larry Smith, CFO, Valley Medical. “And if you focus on clinical quality, the money will follow through appropriate reimbursements.” He attributes the expertise of Nuance and its JATA team and their clinical knowledge to raising the bar on clinical documentation and clinical performance by helping Valley Medical engage physicians.
Using Data to Pinpoint CDI Priorities
Valley Medical had a legacy CDI process in place for 10 years, but administrators believed they were missing opportunities to provide more documentation details for patient cases. A recent HFMA Executive Survey: Clinical Documentation Meets Financial Performance found that a majority of healthcare CFOs and finance executives share this concern. The survey showed that 87% of respondents believe that improving the accuracy of clinical documentation is the greatest opportunity for financial improvement in their organization.
To achieve rapid success with the Nuance CDI program, Valley Medical identified opportunities for improvement, leveraging easy-to-understand reports to see how they compared against peer organizations in terms of patient cases, physician specialties and CMI. They focused on the areas where the clinical documentation did not align with the complexity of a patient’s case. Additionally, they used a unique approach to educate clinicians, coders and clinical documentation specialists and bring teams closer together for the success of the program.
“The Nuance JATA team helped us view the patient with a focus on the clinical information – from admission to discharge – to ensure we capture the complete clinical picture for each patient,” explains Ronna Mahlen, RN, C-CDS lead clinical documentation specialist. “We’re not coders and they’re not nurses, but we learn from each other and the combined team, along with management support, created early success in a program that has proven methodologies.”
“Eighty percent of Nuance CDI customers had prior CDI programs, but when they implement our clinical CDI program with its guaranteed outcomes, they see significant improvements in quality and a 4-8 percent increase in CMI,” says Joanne Webb, senior vice president of healthcare, Nuance Communications. “Instead of focusing on CDI from a coding perspective, we engage physicians and focus on clinical accuracy from the beginning of the patient’s stay, and that difference enhances coding and both clinical and financial outcomes.”
