Mortality Reduction – Part 2

On this episode, we continue our discussion with a physician executive on addressing mortality as a key quality indicator. We focus on using the correct coding and documentation scores for a more accurate representation. We examine the under-use of palliative care, and we discuss how to better work with transfer centers, patients and their families to improve patient experience and hospital mortality scores.
 
Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Executive Principal
Operations and Quality
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
 
Show Notes:
[00:46] Role of documentation and coding
[01:52] Example from neurosurgery notes
[03:20] Gaming the system accusation
[04:12] Ignorance about coders and coding process
[05:10] Surgeons and the medical record
[06:27] Risk stratification and the transfer center in the academic medical center
[08:10] Patient-family involvement in the transfer
[09:16] Use of observation and of virtual care
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Aman Sabharwal’s contact email: aman.sabharwal@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
 
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Mortality Reduction – Part 1

Mortality scores are increasingly an issue for many health care organizations across the country. Obviously, the pandemic had a major role in affecting these scores, but the truth is this was an issue before the pandemic and only rose to attention of the public and regulators from it. Despite the obvious reasons organizations need to address their mortality scores as a key quality indicator, these scores also are a major influence in national quality scores and reputation. Organizations can also use good scores as leverage in negotiations with payers. In earlier episodes, we addressed this issue with a data scientist and a documentation specialist. In this series, a physician executive gives his perspective.
 
Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Executive Principal
Operations and Quality
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
 
Show Notes:
[01:32] Importance of mortality scores
[02:50] Putting the pandemic aside
[03:09] Mortality weighs heavily in rankings
[04:08] Mortality scores and payers
[04:30] The O/E Ratio
[06:11] Four workstreams to address mortality
[08:33] One single thing an organization can do to improve ranking
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Aman Sabharwal’s contact email: aman.sabharwal@vizientinc.com
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
 
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Hierarchical Condition Categories – Part 2

This episode continues the discussion on Hierarchical Condition Categories, or HCCs, examining the impact of HCCs on reimbursement, approaches to risk-adjustment and changes in payment policies.
 
Guest speaker:
Angela Hunt, RN, MBA, CCDS
Principal
Operations and Quality
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
 
Show Notes:
[00:43] RAF scores defined
[01:22] Importance of RAF scores for reimbursement
[03:40] Importance of understanding HCCs and their documentation
[04:07] Risk adjusting patients
[06:07] Payment structures in commercial policies
[06:49] Approach and input from the Vizient team – focus on documentation
[07:59] The future of HCCs and documentation
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Angela Hunt’s contact email: angela.hunt@vizientinc.com
Hierarchical Condition Categories Coding (AAFP) Click here
HCC Fact Sheet (Vizient) Click here
 
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Hierarchical Condition Categories – Part 1

Hierarchical Condition Categories (HCCs) aren’t a new concept, but as more and more organizations shift to value-based care, there has been renewed issue in the subject. This is based on the recognition that without solid foundational knowledge of HCCs, health systems risk lower rates of reimbursement, or sometimes not getting paid at all.
 
On this program, we will explore the use of HCCs and their importance to medical practice.
 
Guest speaker:
Angela Hunt, RN, MBA, CCDS
Principal
Operations and Quality
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
 
Show Notes:
[01:36] Background and definition for HCCs
[02:24] Using HCCs
[02:54] Physicians and clinicians who use HCCs
[04:08] Importance
[05:34] Documentation approaches
[08:47] Deriving value through the HCC designation
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Angela Hunt’s contact email: angela.hunt@vizientinc.com
Hierarchical Condition Categories Coding (AAFP) Click here
HCC Fact Sheet (Vizient) Click here
 
Subscribe Today!
Apple Podcasts
Spotify
Android
Google Podcasts
Stitcher
RSS Feed