Member insight: Aligning metrics to CDI’s mission

by Kati Beisel, MSM, RHIA, CDIP, CCS

Healthcare organizations today are under increasing pressure to achieve a value-based equation by providing high-quality care along with a superior patient and family experience—all at lower costs for their patients. While healthcare reimbursement is certainly changing from fee-for-service to performance-based methodologies, the move is a cautious one and both payment models are still technically in use. As a result, CDI programs are left to grapple with balancing both a case-based financial mission and a quality outcomes mission. Payers’ clinical validation reviews and DRG downgrade practices add to the financial complexity.

As CDI programs evolve and expand, a clearly defined mission and alignment of key performance indicators (KPI) is increasingly important to achieve the desired outcomes.