October 1, 2016
HIM Briefings

For approximately 10 years, HIMB has been gathering data about the HIM profession through its annual salary survey. This survey often gives us a glimpse into the responsibilities of HIM professionals, but focuses primarily on the education, experience, and salary of those in the HIM field.

Time and again, the salary survey reveals that HIM directors and managers are wearing many hats and asked to oversee an increasing number of tasks. In an effort to dig a bit deeper into HIM departments, HIMB conducted its first HIM roles and responsibilities survey.

More than half of respondents were HIM directors (26%) or managers (25%), whereas the remaining 49% held other revenue cycle positions. Of the latter group, 50% were coders and 29% were CDI specialists. Responses also came in from transcriptionists, privacy officers, compliance officers, revenue integrity professionals, and consultants.

HIM demographics

The plurality of respondents work in acute care hospitals (55%) and critical access hospitals (17%) or have a corporate position at a multi-system hospital (8%). Other settings represented in the survey include long-term acute care hospitals, psychiatric/behavioral health hospitals, skilled nursing facilities, ambulatory surgery centers, and physician practices.

October 1, 2016
HIM Briefings

The fiscal year (FY) 2017 IPPS final rule was released August 2 and will be published in the Federal Register August 22. The majority of the finalized updates are consistent with those outlined in the proposed rule, but with a few refinements to applicable time periods. The final rule expands and refines the number of claims-based ­outcomes linked to payment under these programs.

Effective October 1, 2017, performance for cost and quality measures in the HRRP, HVBP, and HACRP will impact up to 6% of your hospital's inpatient acute Medicare fee-for-service reimbursement.

So, where to begin? First, become familiar with the measure specifications and risk-adjustment methodologies, in addition to existing CMS provided reports on historical performance, to gain insights into your organization's clinical documentation and coding vulnerabilities.

Measure specifications can be found at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/....

The final rule is available here: www.federalregister.gov/public-inspection.

October 1, 2016
HIM Briefings

The May 2016 issue of Perspectives outlined 225 hospital requirements from the accreditation manual?nine from the Information Management (IM) chapter and five from the Record of Care, Treatment and Services (RC) chapter?that have been deleted. This initiative is part of the Joint Commission's project REFRESH and improving the survey process. 

October 1, 2016
HIM Briefings

One year following the official implementation of ICD-10, the coding industry is beginning to report valid results regarding accuracy, productivity, and denial trends. While some of these facts and figures are self-reported by HIM directors and anecdotal in nature, other findings are grounded in hard, fast coding performance data. Such is the case with the results from Central Learning (www.centrallearning.com), a web-based system that electronically assesses coder knowledge using real medical record cases and expert-verified answer keys.

This article summarizes coder performance data as measured across 50 health systems and 300 coders as of June 30, 2016. It compares these findings with other industry reports and extrapolates key findings for HIM directors and revenue cycle executives. Since coding and diagnosis-related group (DRG) assignment are the major drivers behind health system revenue streams, consistent data analysis helps to ensure accurate coding and reimbursement.

According to Central Learning data, coding accuracy is slightly increasing after nine months under ICD-10 for both experienced coders and coders-in-training. While the industry overall still lags behind the 95% accuracy benchmark achieved in ICD-9, we're getting closer in all three major patient types: inpatient, outpatient, and emergency services.

Fifty health systems are represented in the data, providing a broad-based assessment. We compared coder accuracy from Q1 (January 1?March 31) with Q2 (April 1?June 30) to identify recent, timely trends in code quality. The figure on p. 13 lists the most current benchmark of our status through June 30, 2016.

October 1, 2016
HIM Briefings

The May 2016 issue of Perspectives outlined 225 hospital requirements from the accreditation manual?nine from the Information Management (IM) chapter and five from the Record of Care, Treatment and Services (RC) chapter?that have been deleted. This initiative is part of the Joint Commission's project REFRESH and improving the survey process.