Ishwaria Subbiah, MD, MS, FASCO

Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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✴ CALL FOR ABSTRACTS ✴ Building data capacity to study health equity in patient-centered outcomes research The Office of the Assistant Secretary for Planning and Evaluation (ASPE) is sponsoring a special issue in the journal Medical Care focusing on patient-centered outcomes research (PCOR). The special issue will feature papers that highlight opportunities focused on how data can be collected, linked, analyzed to support PCOR studies that incorporate a health equity lens to address questions important to patients, caregivers, and communities; clinicians; and policymakers. ✴ Abstract Submission Due Date: 7/1/2024 ✴ Submit here: https://lnkd.in/eJgaHyZJ #healthequity #healthcareequity #PCOR #patientengagement #communityengagement #opportunity #research #data RAND

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📌 Strong cross-team collaboration with shared purpose inspires greater collective contribution. ❓ Have you ever been to a working meeting with a diverse group of teammates in the room where you felt effortless team connection and flow? That was the feeling at our American Medical Group Association (AMGA) Colorectal Cancer (CRC) Screening Best Practices Learning Collaborative this week in Indianapolis. We came #together with shared purpose in learning the best practices across 20 health systems nationally to improve our screening and prevention of colon and rectal cancer in our communities. 📌 We were there to help each other. 🔷 It was easy to listen to other teammates share their ideas, their lessons learned, their missteps and mistakes, their successes to bring back new approaches to help our patients, communities, and care teams at home. 🔷 It was easy to share our Intermountain Health team’s ideas, lessons learned, missteps and mistakes, and successes to help the other health system teams in the room, their patients and communities, and their care teams at home. It was easy to learn. It felt effortless. I think we need more of this in #healthcare. #CrossTeamCollaboration #TeamFlow #WePreventCRCTogether

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I hope everyone is having a great Value Analysis Week and celebrating all the work you do! The 2024 Association of Healthcare Value Analysis Professionals (AHVAP) Value Analysis Week is your platform to explore cost-saving opportunities, improve patient outcomes, and drive value within your organization. We have had two phenomenal presentations so far! Don't miss this unparalleled learning experience! To learn more: https://lnkd.in/eJZSWUVa. #AHVAP2024ValueAnalysisWeek #HealthcareValueAnalysis #HealthcareLeaders

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"How can you ensure patient data accuracy in your healthcare database?" LinkedIn randomly asked me this question, dangling another community topvoice" badge of questionable value like a topdoc award, in front of me. There are great things about LinkedIn which I love, but I don't like its thought policing algorithms. LinkedIn has two types of top voice badges: 1) "topvoice" and 2) "community topvoice". The "topvoice" badges are "invitation only" which LinkedIn appears to give out to, only powerful, or politically correct members, whose posts are always amplified on its platform. I have seen many ordinary posts from some "top voice" members being amplified. LinkedIn cleverly invented the "community topvoice" for the intellectual coolies to train its AI engine to produce so called community knowledgebase articles. LinkedIn's random question today about the accuracy of healthcare database was one such attempt. The video shared with this post is my answer. Watch till the end :) We still love you LinkedIn. #healthcare #healthcaredata #humanresource

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In the face of a looming rheumatology workforce shortage, advanced practice providers such as #PhysicianAssistants, #nurses and #NursePractitioners have stepped up — to an astounding degree. 💥 Between 2009 and 2020, the number of #APPs in #rheumatology skyrocketed 141%, while #rheumatologist numbers barely moved the needle with a paltry 23% growth 🤯 Some experts see this as a welcome opportunity not just alleviate the #WorkforceShortage, but to ultimately grow the specialty. Others hold real concerns that the steep learning curve of a busy rheumatology practice means that APPs are learning while on the job — particularly worrisome since practices that need APPs the most are those that are already overwhelmed. “I have had the privilege of working with many APPs,” Dr. Jeffrey Curtis at University of Alabama at Birmingham told Healio. “I have seen some who have a lot of training and experience in rheumatology and others who have trained 6 to 8 weeks or less. Consequently, some APPs understand the scope of our diseases and others have no idea what a chronic condition looks like.” 🔥 Have a hot take on APPs in the workforce? Join the conversation 💬 https://lnkd.in/ePqNMKwN

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Great summary, Reed Omary, MD, MS, of some of the major factors impeding action on climate and sustainability in healthcare (1. not our business; 2. costs money and 3. we are too busy). The major question that has occupied me since you and I spent time together in Sundance (at a great climate and health conference organized by Vivian S. Lee, MD, PhD, MBA - see https://lnkd.in/gdw6nsSE) is what needs to happen to create a tipping point in which rapidly accelerating positive action feeds on itself. Healthcare is still largely a cottage industry, but maybe this is as much an opportunity as it is a challenge. One thing we know is that healthcare employees want to see their employers act (see https://lnkd.in/gg5Xt5QU). I think that may be one of the biggest leverage points ... !

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An Outpatient Clinical Documentation Improvement (CDI) program offers substantial advantages to healthcare organizations by elevating patient care and operational efficiency. By integrating risk stratification with chronic conditions, enhancing quality measures, addressing social determinants of health, and establishing a collaborative team empowered by technology, such strategic initiatives result in improved patient outcomes and streamlined operations.

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𝗖𝗼𝗻𝗾𝘂𝗲𝗿 𝗖𝗼𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗻𝗴 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀: 𝗦𝘁𝗿𝗲𝗮𝗺𝗹𝗶𝗻𝗶𝗻𝗴 𝗖𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗗𝗼𝗰𝘂𝗺𝗲𝗻𝘁𝗮𝘁𝗶𝗼𝗻 𝗳𝗼𝗿 𝗢𝗽𝘁𝗶𝗺𝗮𝗹 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗖𝗮𝗿𝗲 🩺 Inconsistencies in clinical documentation aren't just paperwork problems; they're potential revenue leaks and compliance pitfalls. 😢 It's no surprise that fragmented documentation can obstruct clear communication and coordinated patient care. The repercussions? They're real and damaging. Ignoring this looming concern can lead to financial setbacks, compliance hiccups, and even undermine the quality of patient care. Here's your game plan to seal those gaps: 📌Develop and enforce documentation guidelines and templates. 📌Establish a clinical documentation committee. 📌Integrate algorithms in your EHR systems. 📌Implement peer-to-peer documentation review. Embracing these best practices can amplify communication clarity, uplift patient care quality, ensure accurate billing, and dodge those pesky compliance troubles. 💬 Standardized clinical documentation – it's a journey. How's your organization navigating it? Drop your stories and strategies below! 👇 ➖➖➖ Over the last 25+ years as an MD with an MBA and MPH, I have worked with 3 Multi-Million dollar Hospital organizations serving as VPMA and CMO saving millions of dollars and improving quality. I went on to serve as Chief Physician Executive for BDO USA, the fifth-largest professional services firm in the United States. The key to my clients' success has been my proprietary ACCESS Methodology. Assess Coach Consult Execute Strategize Simplify Today, I run my own organization helping hospital executives solve their “Burning Issues”. For a limited time, get my newest ebook for free: "Caught in the Crossfire: The 5 Executive Errors That Ignite Corporate Crises in Hospitals”. Quickly learn 5 critical hospital mistakes and how to fix them. ***** 👉 Type “PDF” in the COMMENTS, and I will send you a FREE PDF copy. #healthcare #innovation #mentalhealth #management #law #compliance

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📢 Mixed news regarding Missouri’s recent Medicaid provider bulletin indicates an expansion of coverage for Silver Diamine Fluoride (SDF) treatments. As of April 1, 2024, individuals in nursing homes and other adults up to the age of 20, including pregnant and blind residents, now have access to this important caries-arresting treatment. This is a monumental step beyond the previous limitation to children under the age of 5. However, amidst this progress, we must address a significant oversight: the exclusion of patients with Intellectual and Developmental Disabilities (I/DD) from this expansion. Those with I/DD are among the most vulnerable and frequently require specialized dental care that SDF can provide. It’s essential for Missouri leaders to recognize and bridge this gap to ensure equitable oral healthcare for all, especially for those who cannot easily advocate for themselves. I urge our state’s policymakers to revisit the expansion and amend it to include our I/DD community. They deserve the same access to preventative oral health measures as any other group covered under this new policy. #DentalCare #OralHealth #SDF #Medicaid #Missouri #Inclusion #HealthEquity #IDD #DentistryAdvocacy Missouri Coalition for Oral Health Missouri Dental Association American Dental Association Missouri Department of Health and Senior Services Missouri Division of Developmental Disabilities Brad Christ Mike Parson

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Virtual care and digital health tools will require leaders to implement technology and develop team models to address widening rural health care disparities.

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It is important to have solutions that fit the need of various organizations. One size does not fit all. #costsavings #healthcaresupplychain #valueanalysis #hospitalfinance

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Want to elevate your marketing with a Leapfrog produced webinar about your product, service or technology? Join the Leapfrog Partners Advisory Committee or PAC and we will! Learn why more than 30 companies have joined! palper@leapfrog-group.org

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CDC media statement: Today’s data (https://lnkd.in/eNUyyPbQ) showing a decrease in drug overdoses over the 12-month period through December 2023 is heartening news for our nation and demonstrates we are making progress to prevent deaths from drug overdoses. The decrease is a testament to the hard work by all of our partners in this effort and the work being done on the ground as part of a coordinated federal effort on prevention, services, and harm reduction. However, this does not mean we have accomplished our mission. The data show we still lost over 100,000 people last year; meaning, there are still families and friends losing their loved ones to drug overdoses at staggering numbers. This progress over the last 12 months should make us want to reinvigorate our efforts knowing that our strategies are making a difference. I encourage all of our partners to continue the incredible work they are doing as part of the national strategy. Our thoughts remain with those who have lost loved ones and those who are struggling with addiction or know someone who is. Our country is committed to ending this epidemic and preventing unnecessary death and suffering

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Giuliana Grossi, writing for the AJMC - The American Journal of Managed Care, summarized key insights from the "Implementing Health Equity Through Value-Based Care for People in Medicare" session at the CMS Health Equity conference. Experts discussed innovative strategies to enhance health equity, particularly in postacute care and fee-for-service Medicare. Cindy Massuda and Chris Palmer presented groundbreaking work on health equity in postacute care, focusing on data collection and feedback reports to address disparities. Palmer outlined efforts to integrate health equity into the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, including the Health Equity Adjustment (HEA) to reward facilities serving dual eligible residents. Maya Peterson provided updates on care management services within the Physician Fee Schedule (PFS), emphasizing social determinants of health (SDOH) risk assessment, community health integration, and principal illness navigation (PIN). Lucy Bertocci discussed the Medicare Shared Savings Program's (MSSP) Advance Investment Payments (AIP), aimed at supporting accountable care organizations (ACOs) with upfront costs. The session highlighted the importance of addressing health-related social needs, stratifying data to understand disparities, and supporting ACOs through innovative payment models. Centers for Medicare & Medicaid Services #HealthEquity #Medicare #ValueBasedCare #InnovationInHealthcare https://lnkd.in/gQPHhKUG

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Join me at our live webinar on May 15 to learn more about the newly defined standard Part D benefit. 

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Check out #HDPulse by National Institute on Minority Health and Health Disparities (NIMHD)! The data portal makes it really easy to view data (by topic, temporally, and geographically) and the interventions portal looks like it will be quite useful when released. #socialdeterminantsofhealth #healthequity #data

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"HaH has been demonstrated to provide safe, high-quality care in dozens of clinical trials," but will lose traction if the CMS waiver temporarily allowing it ends in December. Congress will need to act to make the waiver permanent. 🤞 Please read, share, and write your Congressional representatives!!!! #HaH #Healthcare #HospitalWithoutWalls #Hospitalathome

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