Clinical Documentation Improvement

It’s Time to Revitalize Your CDI Program—The Why and How of BPCI

It’s Time to Revitalize Your CDI Program—The Why and How of BPCI Clinical Documentation Improvement (CDI) programs have experienced significant transformation over the last decade. Under the new MS-DRG (Medicare Severity-Diagnosis Related Group) system—a major driver for many hospitals and health systems to invest in CDI programs—capturing CC/MCCs (complication or comorbidity and major complication or comorbidity) became the focus. Many organizations that have implemented an MS-DRG focused review program have seen success, experiencing benefits in improved provider documentation and true…

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How the Recent CMS Update Will Impact Traditional Medicare Reimbursement with MACRA

How the Recent CMS Update Will Impact Traditional Medicare Reimbursement with MACRA At the beginning of February 2018, the Centers for Medicare & Medicaid Services (CMS) proposed raising Medicare Advantage plan payments by an average 1.84 percent in 2019. In a more recent announcement dated April 2, 2018, CMS proposed an increase in Medicare Advantage plan payments from the original estimated 1.84 percent to 3.4 percent based on improvements in data submissions. CMS is committed to strengthening the Medicare Advantage…

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