A Mid-Atlantic based health system operates under Maryland's All-Payer Model and faces the challenge of accurately capturing performance measures to participate in the Centers for Medicare & Medicaid Services's (CMS) Total Cost of Care (TCOC) Model. Under Maryland's evolving payment models, capturing accurate clinical documentation for coding episodes of care is vitally important, especially with regards to quality measurement.
The health system's traditional physician query methods faced a number of challenges, primarily centered around physician engagement and process standardization. Physicians were responding to queries about 60% of the time, and on average it was taking them 12 days to respond. For the query authors, tracking and following up on non-responses also presented a challenge.
The organization wanted a clinical documentation improvement (CDI) tool that would promote engagement, achieve physician satisfaction and drive standardization of query templates and methods.
The health system chose Artifact Health's mobile query solution to realize its vision for reducing burden on physicians and easing the hospital revenue cycle teams' documentation improvement efforts.
"We are committed to quality improvement and Artifact's technology will give us the opportunity to grow and scale our clinical documentation improvement efforts reaching all of our providers with an easier, more efficient way of handling documentation clarification requests," said IT leadership for the health system.
Further, the health system must ensure quality-based reimbursement metrics are accurately coded and reported because they are heavily weighted in Maryland. Artifact would give CDI specialists and coders a faster and more convenient way to communicate with providers about the quality of care provided.
"This was the best go-live preparation and smoothest go-live that I have been involved in over my many years of working in a HIM environment!"
– Coding Leadership for the Health System
The Artifact platform proved to be faster and easier for physicians, giving them more time to care for patients while improving the accuracy and quality of the health system's clinical documentation. Within two months of going live on the Artifact system, physician response rate jumped from 60% to 99% and response times dropped from 12 to 5 days.
An added benefit of the near-perfect response rate over the same time period was that the case mix index (CMI) increased significantly. "We know our CMI is only as good as our documentation, so having these responses is critical," said HIM leadership for the health system.
Artifact also standardized the CDI and coding teams' approach to delivering queries and significantly reduced their follow-up workload. The real-time reports available in Artifact made the query process transparent, allowing them to see who was not responding and address gaps with focused education.
"This was the best go-live preparation and smoothest go-live that I have been involved in over my many years of working in a HIM environment!" said coding leadership for the health system.