HIM role in quality initiatives
HIM Connection, January 17, 2012
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Quality initiatives are here to stay, and there are new ones popping up all the time. Ignoring them because your facility does "a pretty good job" isn't really an option. When it comes to several of the new quality initiatives, HIM plays a key role. Consider the following:
- Value-based purchasing (VBP). Medicare is already looking at data for this new program, which officially takes effect in 2013. Coders play a role in assigning principal diagnoses, as well as secondary conditions, complications, and present on admission (POA) indicators. What should HIM managers do to help ensure their team is submitting good data? Educate, for one, said Geissler. Use Coding ¬Clinic to review coding guidance with coders and even physicians.
- Readmissions Reduction Program. This program will measure 30-day readmissions for heart failure, acute myocardial infarction, and pneumonia, and its financial effects will take effect in 2013. HIM's response should be to verify coders are reporting all of the secondary conditions, said Kristen Geissler, MS, PT, MBA, CPHQ, principal at Berkeley Research Group in Baltimore. "Use those spots, up to 25. That's what we should put on that record, as many codes as possible," she said. Accurate assignment of discharge disposition is also important.
- Healthcare Acquired Conditions (HAC). CMS has been monitoring HACs for a few years now, but financial penalties will increase in 2015. The inpatient prospective payment system details changes to the list of HACs every year. Again, HIM needs to ensure accurate POA indicator assignment and complication coding, Geissler said.
Editor’s note: This tip has been adapted from an article which originally appeared in the January issue of Medical Records Briefings.
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