Engaging Physicians in Documentation

1. Engaging Physicians in Documentation Executive Summary Revenue Cycle Solutions Physician Documentation Initiative Why documentation matters more than ever (p. 2) Components of the Advisory Board’s Physician Documentation Initiative (p. 3)

2. Poor Documentation Adds Up Capture Additional Revenue Good documentation has a significant impact on a hospital’s financial health. The Advisory Board estimates that an average 250-bed hospital with insufficient documentation practices lost $7.1M in 2013 alone. Even at top performing hospitals, current efforts to improve documentation aren’t cutting it. At an average top performing 250-bed hospital, current investments only make up $1.6M of the $7.1M in documentation losses. Adapt to New Demands The stakes are increasing every day. The rise of value-based purchasing and the transition to ICD-10 bring the need to improve the specificity of documentation. The expanding availability of health care quality data to insurers, regulatory agencies, and the public means that hospitals need to ensure that what is being reported accurately reflects the quality of care provided. Revenue Loss from Missing Documentation Average 250-bed Hospital Documentation Matters More Than Ever • Growing administrative burden on physicians • New payment models • Pay-for-quality • Increasing specificity in ICD-10 -$12.8M Revenue Loss from Missing Documentation Top Performing 250-bed Hospital • CDI program • CAC • Documentation training

3. Evidence Motivate Poorest Performers First Words Do Matter Training your physicians to document effectively is critical to your financial success. But training is for naught if it falls on deaf ears. All hospitals struggle with motivating poor documenters to change their habits. The first step of any training effort should be to show these folks how what they write matters—to them, in the form of quality scores and increasingly reimbursement, and to the hospital. Benefits Today and Tomorrow Engaging your poor documenters today reaps immediate rewards from better documentation under ICD-9 and sets you up to make the most out of training for ICD-10. Expertise Exclusivity Engage Physicians in Documentation Now for Immediate Impact • Documentation Effectiveness Matrix Step 2 Sustain High Step 1 Engage Documentation Skill Low Low High Engagement in Documentation Improvement How to Make the Case to Physicians • One-on-one meeting • Individual data • Clinical knowledge • Unbiased • Effective messaging • Impact on quality • Real life examples • Trend identification

4. The Crimson Continuum of Care Advantage Understand Your Performance We build a customized analytics platform for every Physician Documentation Initiative member based on our proven Crimson Continuum of Care product. Crimson Continuum of Care creates severity-adjusted performance profiles for each of your physicians so we can compare performance on the full range of cost and quality measures . We use the analyses to investigate potential documentation opportunities, pinpoint individual cases with variance, and uncover the root cause of underperformance. Extensive Quality Data for Key Physicians and Cases All data is severity adjusted Investigate the drivers of performance for specific physicians and cases Details of outlier cases, including physicians, diagnoses, severity levels, utilization and regulatory measures

5. How We Choose Target Physicians • Focus Your Efforts • You will achieve greater success in documentation improvement by providing individual attention to the physicians with the biggest opportunities. Our primary focus is physicians with substantial opportunity to improve their performance today. • We identify the physicians who have the most power to influence performance in problem areas and rank them based on two characteristics: ICD-9 opportunity and ICD-10 risk. The result is a prioritized list of physicians to target for further investigation and training that will serve you well today and tomorrow. Documentation Opportunity Matrix Training Efforts Focused on Physicians with Greatest Potential Impact Intersection between ICD-9 opportunity and ICD-10 risk High ICD-10 Risk Med Low ICD-9 Outlier Cases

6. Making a Compelling Case to Physicians Training to Meet Your Needs In some cases, group education makes sense because an entire specialty is affected the same way. But for the highest-priority physicians there is no substitute for one-on-one training using individual performance data and specific documentation examples. • Our team will lead personalized, one-on-one training sessions with key physicians. We prepare customized training materials that include the physicians’ individual performance data, examples of subpar documentation, and specific recommendations to improve. One-on-One, Face-to-Face Meetings Individual financial and quality data Chart review Clinical expertise Effective messaging Customized, One-on-one Training Motivates Key Physicians ” The Power of Personalization Custom materials for each physician with their own cases and data What particularly hit home for me was that they actually used some of my records from the past and generated some data and could show me exactly where I could improve.” Orthopedic Surgeon Fletcher Allen Health Care Burlington, VT By the time they see their own charts, physicians want to solve the problem Progression of the Training Presentation National Trends Hospital Performance • Specialty Performance • Individual Performance

7. Targeted Training to Reach Each Part of Your Team Stay Engaged in Documentation Ongoing training is required to fully leverage the benefits achieved during our initial one-on-one training sessions. Our documentation experts will provide comprehensive materials for initial study and later review a variety of topics that will help sustain physician engagement. We’ll give you the tools you need to keep your staff and physicians engaged in documentation moving forward. Follow-Up Training Sessions Help You Sustain Momentum • Train the Trainer • These sessions will: • Help physician leadership or CDI staff carry forward the Physician Documentation Engagement concepts • Show staff how to teach new physicians about documentation • Share general documentation best practices • Refresher Meetings • These sessions will: • Review for physicians the concepts discussed during their initial conversation • Reinforce important messages • Answer physician questions about documentation • “Why Words Matter” • These sessions will: • Spread organizational awareness about the importance of physician documentation • Emphasize the concepts taught in one-on-one sessions Additional Topics Covered • Anatomy of best practice CDI team: set up • How best to communicate to physicians and have an impact • How to look at data • How to look at charts • How we think about a chart compared to coding or CDI review • Shadowing and live-coaching with CDI team • Coaching on working with difficult physicians