HHS Announces New Medicare Alternative Payment Models to Reward Better Care at Lower Cost

Today, the Department of Health & Human Services finalized new Medicare alternative payment models that continue the Administration’s progress in reforming how the health care system pays for care. These new approaches will shift Medicare payments from rewarding quantity to rewarding quality by creating incentives for hospitals and clinicians to work together to avoid complications, avoid preventable […]

Here are 6 points you must read before you hire your next CDI resource


Many CDI Managers insist on having all their CDI staff onsite. Having all your staff in-house in many instances can be counter productive. Here are 6 points on why you should also consider remote CDI specialists in your staffing mix: You will have access to a much larger talent pool to hire from enabling to you hire better […]

Hospital outpatient departments to be impacted significantly by 2017 OPPS Final Rule from CMS

Center for Medicare & Medicaid Services (CMS) has released its Final Rule for Hospital Outpatient Prospective Payment System  OPPS) for CY2017 with significant implications to hospital outpatient departments. Let me first give you the good news. For CY 2017, CMS is updating OPPS rates by 1.65 percent. The change is based on the projected hospital market basket […]

Front End Speech Recognition: A case of dime wise and dollar foolish?

A new study sponsored by Agency for Healthcare Research and Quality (AHRQ) identified the frequency with which errors occur when physicians use front end speech recognition. ” Critical errors were found in 15 percent of data entered into patients’ electronic health records by physicians using computerized speech recognition technology, according to a pilot study funded […]

Hospital readmission rates are falling across the country

Potentially avoidable hospital readmissions that occur within 30 days of a patient’s initial discharge are estimated to account for more than $17 billion in Medicare expenditures annually. Not only are readmissions costly, but they are often a sign of poor quality care. To address the problem of avoidable readmissions, the Affordable Care Act created the Hospital […]

CMS launches ‘Pick Your Pace’ options for physicians as part of Quality Payment Program

As part of CMS’ move to link physician payments to patient outcomes, the Quality Payment Program put in place by CMS is set to begin on January 1, 2017. CMS has shared plans for the timing of reporting for the first year of the program. It allows Quality Payment Program to allow physicians to pick their […]

Here are 10 questions to ask before you buy CDI software

1)      Does the software minimize data entry? If your CDIS have to enter all the codes and DRGs manually and also analyze that data for reimbursement manually it severely hampers their productivity. You want your team to be more efficient and productive. 2)      Does it come with built-in ICD-10 compliant query templates or do you […]

Four reasons why hospitals have to start outpatient CDI programs now

Clinical Documentation Improvement

Here are four reasons why hospitals have to start their outpatient CDI programs now and not later. 1) Hospital revenues are shifting from inpatient to outpatient Historically, 92 percent of Medicare revenues to hospitals have come from inpatient and outpatient services. Over time, however, the share of revenue coming from the outpatient setting has increased, […]

Starting next week all hospitals have to start serving the MOON to patients

The Notice of Observation Treatment and Implication for Care Eligibility Act (the NOTICE Act), which was enacted on August 6, 2015 law requires hospitals and critical access hospitals (CAHs) to provide written notification and an oral explanation to individuals receiving observation services as outpatients for more than 24 hours. This notification must be provided no […]

CMS is set to release single star hospital overall quality ratings soon

More than 74% of the hospitals in the country score less than three stars in this new Five Star Rating system. Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide care to their patients. This information can help consumers make informed decisions about their health care. In a major step to […]