Case Study: Establishing a Strong Financial Foundation through a Commitment to Quality

A healthcare organization in the South, operating two campuses and handling 11,000 annual discharges, partnered with AMN Healthcare to address and improve their quality scores.

AMN Healthcare’s root cause analysis uncovered gaps in capturing the full clinical picture of the patient population, leading to a lower-than-expected Case Mix Index (CMI) and resulting revenue losses. Recognizing the importance of a higher CMI for reimbursement, the organization, with C-suite support, collaborated with AMN Healthcare to establish a Clinical Documentation Integrity (CDI) program. This initiative, staffed by both internal and externally recruited nurses trained at AMN Healthcare’s Inpatient CDI Academy, focused on enhancing documentation accuracy to reflect patient complexity. The improved documentation elevated the CMI, aligning it with the level of care provided and supporting higher reimbursement rates. As a result, the hospital saw improvements in quality reporting, financial stability,
and a $600K revenue increase in the first quarter.