Note from the Advisory Board: Stay relevant in changing healthcare landscape

By Sam Antonios, MD, MMM, FACP, SFHM, CPE, CCDS
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how complex it was, and then saw that the reimbursement only paid for half the cost of caring for that patient. That’s how clinical documentation improvement (CDI) was born. To put it simply, CDI was formed because there were data errors that led to financial cost. However, continuing with the same focus and method—reviewing records for accurate reimbursement—is myopic.