Symposium Speaker Highlight: Whitley shares story of ambulatory success

Editor’s note: There are only 45 more days left until the first ever ACDIS Symposium: Outpatient CDI, September 18-19, in Oak Brook, Illinois. Last week, we brought you a Q&A with Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, in CDI Strategies, but she’s not the only Symposium speaker we got to know recently. Today, we spoke with Yvonne Whitley, RN, BSN, CRCC, CPC, CRC, the supervisor for Novant Health Medical Group’s Ambulatory CDI team, who will present “Novant Health ambulatory CDI—How we’ve grown!” at the event. Please note that this event is filling up fast with limited seats remaining.

Q: Can you explain why you use the term “ambulatory” rather than “outpatient?”

A: The simple answer is that “outpatient” refers more to facilities such as wound care, same day surgery, infusion centers, etc. “Ambulatory,” on the other hand, refers to the provider clinics. Currently we only focus on the ambulatory setting.

Q: What was the biggest challenge you encountered during the implementation of your ambulatory CDI program?

A: The lack of any resources available for ambulatory CDI when we began in 2013. There also aren’t any tools that can specifically give a return on investment since we’re affecting the risk adjustment factor (RAF) scores which doesn’t necessarily give us a dollar amount. Instead, we had to focus on quality measures.

Q: How does the shift from fee for service to value based care affect ambulatory CDI?

A: Well, what providers do today (via claims and diagnoses) will impact their reimbursement and shared savings in the future. Providers must understand the importance of showing how complex their patients really are. Honestly, the mindset needs to shift away from volume to quality, which is completely opposite to what they’ve been used to. RAF and Hierarchical Condition Category (HCC) diagnoses capture are both extremely important to the value based model, so what we do in the ambulatory CDI space is instrumental.

Q: How have you obtained administrative support for your ambulatory program?

A: Honestly, it was really our leaders’ understanding how fundamental RAF and HCC capture is to the value based care model. Once providers understand that, they’re much more willing to support your efforts. In my opinion, if you don’t have an ambulatory CDI program, you’re missing the boat!

Q: One last fun question: What’s your favorite candy?

A: I love Reese’s Peanut Butter Cups!