Defining Roles, Leveraging Technology Top the List of CDI Leadership Challenges

Changing payment models and the push for quality metrics and all-payer reviews are among the bigger shifts impacting clinical documentation integrity (CDI) programs in 2020. With such disruption, CDI leaders face an important question: What are the best key performance indicators (KPI) to track progress and measure success? What are the ways that CDI departments can demonstrate meaningful improvements and impact as healthcare reimbursement shifts from fee-for-service to pay-for-performance?

This industry focus report offers some suggestions from three leaders of high performing CDI programs. They discuss the base metrics they monitor including chart review rates, query review rates, provider response rates, and more, as well as the baseline percentages that indicate success in their respective programs. Also discussed are areas of expanded focus including CDI impact on quality initiatives, service-line specific metrics, collaboration with case management on length of stay metrics, and expansion into outpatient services, and some of the KPIs used.

 
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