Unique Program Engages Physicians and Drives $45 million in Appropriate Reimbursement at Five Affiliated Hospitals
BURLINGTON, Mass., November 22, 2016 –Nuance Communications, Inc. (NASDAQ: NUAN) today announced that Baptist Health South Florida has realized $45 million in increased appropriate reimbursement since the implementation of Nuance Clinical Documentation Improvement (CDI), which optimizes the accuracy and efficiency of physician documentation and communication of patient care. Not only did Baptist Health significantly improve financial outcomes, it improved the tracking and reporting of patient’s clinical conditions, which more than doubled metrics including severity of illness (SOI) and risk of mortality (ROM) to directly impact quality of care and treatment decisions.
Baptist Health South Florida deployed Nuance’s CDI program across its five hospitals in October of 2011. The improved accuracy and completeness of physician documentation generated a 13% increase in Case Mix Index (CMI) across the system, which translated to $45 million in appropriate reimbursement over the course of four years. The system’s largest hospital alone saw a 14% CMI increase and a financial impact of $26.5 million, supporting the care of sicker patients than originally documented.
“The goal of the CDI program is to make sure the final codes accurately reflect the complexity and severity of a patient’s illness, promoting accuracy and higher quality of the medical record,” said Dr. Lorena Chicoye, corporate medical director of managed care at Baptist. “Once the Nuance clinical documentation program was up and running, it was amazing how much more documentation we were able to capture and the greater specificity we experienced. Now, our documentation more accurately reflects the high quality patient care our physicians are delivering.”
Better Insights into Patient Care
Through Nuance’s Advanced Practice CDI™ program, Baptist Health more accurately documented the disease acuity of its patient population, which doubled its reporting of severity of illness from 8% to 17.1%, and the mortality risk from 7.7% to 14.5%. Clinicians are now able to provide a more complete and detailed picture of a patient’s health to recommend better treatment plans, provide better patient outcomes and more accurately reflect quality especially when publicly reported.
“Nuance is focused on helping clinicians advance quality of care in their communities while also supporting the business of healthcare by helping organizations successfully transition to value-based payments (VBP)” said Satish Maripuri, executive vice president and general manager of the Healthcare Division, Nuance Communications. “Nuance’s award winning clinically-focused CDI approach leads to better overall quality ratings and patient care along with tangible financial outcomes, which directly impact how providers are paid. Baptist Health South Florida is a great example of what a Nuance CDI program can do.”
Physician Engagement Drives Gains
Once Nuance CDI was implemented, physicians could receive clarifications and make adjustments on diagnoses while patients were still in their care before details were missed. This improved the documentation process, and also improved education and physician response rates, thereby capturing more accurate severity and mortality rates, which ultimately impact the quality outcomes of hospitals. By instilling CDI best practices, the Baptist team went from a 20% response rate from physicians to a 95% response rate and most agree to recommended improvements for their documentation.
In addition to using innovative tools that facilitate documentation in real-time, Baptist Health employed international physicians as clinical documentation specialists. Because they are physicians, they have the clinical knowledge essential to help translate clinical speak into documentation requirements that are important in patient charts to support ICD-10 codes and quality metrics.
“We use international physicians as clinical documentation specialists because doctor-to-doctor communication works best when making suggestions about what they should do differently,” said Dr. Chicoye. “We recruit physicians who are medical graduates, ready and waiting to get into residency programs. Using the physicians as clinical documentation specialists has reduced physician resistance to CDI, because they use the same clinical terminology and can speak with authority.”
Nuance provides intelligent systems that support a more natural and insightful approach to clinical documentation, freeing clinicians to spend more time caring for patients. Nuance healthcare solutions capture, improve and communicate more than 300 million patient stories each year helping more than 500,000 clinicians in 10,000 global healthcare organizations to drive meaningful clinical and financial outcomes. Nuance’s award-winning clinical speech recognition, medical transcription, CDI, coding, quality and medical imaging solutions provide a more complete and accurate view of patient care.
Nuance Communications, Inc.
Nuance Communications, Inc. (NASDAQ: NUAN) is a leading provider of voice and language solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with devices and systems. Every day, millions of users and thousands of businesses experience Nuance’s proven applications. For more information, please visit www.nuance.com. Connect with Nuance on social media through the healthcare blog, What’s next, as well as LinkedIn, and Twitter.
Trademark reference: Nuance Clintegrity, Nuance CDI, Nuance's Advanced Practice CDI program are registered trademarks of Nuance Communications, Inc. or its affiliates in the United States and/or other countries. All other company names or product names referenced herein may be the property of their respective owners.