Outsourcing Medical CodingThere’s good news for medical coding companies and clinical documentation experts like medical transcription companies. A Health IT Analytics article reports that a pair of recent industry polls by Black Book show that outsourcing coding, transcription, and clinical documentation improvement (CDI) efforts has evolved into a winning strategy for many healthcare organizations seeking to enhance their case mix and data integrity.

The ICD-10 transition put the focus on CDI and electronic coding, but it was the adoption of the new code set that made it important to maintain a high level of healthcare data integrity. The findings of the Black Book surveys are as follows:

  • In one survey, three-quarters of hospitals and physician groups said that outsourcing has improved coding accuracy since the 2015 switch to ICD-10. Up to 85% of clients who outsourced their computer-assisted coding (CAC) and CDI tasks said that experienced quality improvements and increases in their case mix index.
  • In a related survey, 87% of hospital financial officers reported that increases in case mix index was one of their main motivators for undertaking a CDI initiative.
  • Up to 70% of outsourcing clients are planning to extend their current contracts until 2020, which is a sign of high satisfaction with their decision to outsource.
  • 92% of outsourcing clients expressed satisfaction with their vendor relationships and reported that outcomes exceeded their expectations.
  • Medium to large hospitals got significant rewards through CDI outsourcing. Nearly 90% of those that outsourced their CDI tasks saw reimbursement increases of at least $1.5 million.
  • Interest in outsourcing increased with ICD-10. Twenty percent of hospitals that do not yet have an end-to-end health information management (HIM) system, computer-assisted coding system (CAC), CDI, or transcription solution from a single vendor are “seriously considering” doing so in 2018. This is almost double the number of healthcare organizations that considered a total outsourcing strategy before ICD-10.
  • Voice-to-text transcription services are gaining in popularity and proving effective to decrease clinical documentation burden of healthcare providers.
  • The survey respondents said cost-effective technology packages of experienced health IT vendors have improved quality and integrity of clinical documentation.
  • 83% of hospitals said that, within one year of adoption, their transcription costs fell by half or more, while improving transparency of their dictation and transcription processes.
  • 90% reported that outsourcing streamlined their operations without negatively impacting clinical workflows.
  • 94% of physician groups and practice associations said that CDI is an critical area of focus to help meet the many challenges of value-based care in the outpatient setting.

Medical CodingHigh-quality clinical documentation is necessary for successful big data analytics initiative as well as a necessity for payment. When it comes to data, both data governance and information governance are crucial. Data governance involves managing data assets throughout their lifecycle to ensure that they meet organizational quality and integrity standards. Good data governance will results in reliable data, which is crucial for making patient care decisions. AHIMA defines information governance as “an organization-wide framework for managing information throughout its lifecycle, and for supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental requirements.”

Data governance and information governance are complementary. Each individual data set has to be clean, accurate, standardized, and comprehensive before it can be used with other information to produce actionable insights.

While being crucial to ensure appropriate and timely reimbursements from payers, a successful CDI program is necessary to avoid costly penalties for non-compliance. Outsourced end-to-end medical coding services help with this. Medical transcription and medical coding outsourcing improve EHR usability and make it easier for physicians to create and maintain clean, complete, accurate, and reliable documentation for billing and clinical analytics purposes.

Up to 83 percent of stakeholders participating in a Health Catalyst survey said that big data analytics are “extremely important” for helping healthcare organizations see a return on their electronic health records (EHRs) investments. With the focus on value-based reimbursement and the increasing prominence of accountable care organizations, healthcare providers are under pressure to accurately document their diagnoses and services for performance measurement purposes. This has increased the demand for CAC, CDI and transcription solutions to manage the growth in the volume of structured clinical documentation, according to a Black Book analyst. Experienced medical billing and coding companies can provide solutions that increase coding accuracy, reduce overhead, and improve claims process productivity.

As healthcare providers implement alternative payment models, the support of a reliable technology partner is vital for leveraging clinical data for predictive analytics, risk stratification, business intelligence, and other big data analytics initiatives.