News: Declines seen for inpatient admissions

Since the Institute of Medicine’s November 1999 report “To Err is Human,” a new mantra regarding the structure of healthcare delivery and reimbursement emerged. Today, government reimbursement methods increasingly focus on pay-for-performance, pay-for-quality measures, and strict adherence to rules governing when a patient may be admitted to the hospital for care. Couple these movements with the recent great economic “recession” and the forecast for hospital businesses looks grim, according to recent news reports.

In earnings reports, some of the biggest U.S. hospitals blame weak performance on flagging hospital volumes, according to an article in Modern Healthcare. A report in Healthcare Finance News, states that analysts at both Moody’s Investors Service (in a November 2013 report) and Standard & Poor’s predict a continuing decline in inpatient volumes due at least to some extent to a shift to outpatient care rather than inpatient services.

The theory goes that as inpatient volumes decrease so will hospital revenues. For CDI specialists, this means capturing accurate data for each and every inpatient admission but it may also mean expanding horizons for the future, according to Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDI, an independent consultant based in Madison, Wisc.

Just as hospitals will need to integrate their businesses to provide care across a continuum, so too will CDI departments need to explore ways to provide value to those various service lines, he says. Outpatient CDI is looking more and more like the wave of the future.

Editor’s Note: Learn more about CDI efforts in the outpatient arena in the following articles: