AI-Powered Coding Solutions Reducing Costs and Ensuring Appropriate Quality of Care in the Dash to Value-Based Care, Reports Black Book Survey

Growth in clinical documentation market is expected to reach US$5.2B by 2022 from $3.2B at fiscal year-end 2018 with a 10.2% CAGR

​​The healthcare industry is at the crossroads of widespread adoption of VBC models in a consumerism ecosystem along with increasingly stringent regulation, accurate documentation has become the key driver of hospital revenue systems.

Computer assisted coding (CAC) is a comprehensive technology that includes the amalgamation of various facets of artificial intelligence and natural language processing where CAC is capable of scrutinizing and interpreting unstructured clinician notes. The rigorous task of extracting identified data from documents to fit into established systems is no longer an issue.

44% of healthcare organizations already report using AI in one form or another, and 88% of surveyed C Suite officers expect widespread implementation in the next 5 years. IT leaders have been sent their marching orders to prepare to implement AI with a security-first mindset as the potential for hacking is high, but the potential benefits are massive.

In a survey of 3,300 coding and health records professionals from 278 hospitals and 1,889 physician practices by Black Book, 93% are optimistic that AI technology can streamline document creation and enable clinicians to capture a holistic patient history to boost outcomes but also improve revenue integrity.

An additional 405 provider respondents that have not yet fully implemented or optimally using coding, CDI and transcription technology provided insight on budgeting, adoption plans, factors driving coding and transcription decisions and vendor awareness.

Results reported from participating surveyed in the current year surveys: 

  • Complex denials have dropped on average by the respondent hospitals 21% over the last 2 years ($250 million of hospital charges denied by payer in 2016, down to $198 million in 2018).

  • Coder Productivity Q3 2019 as compared to Q3 2017 has increased 55% in hospitals over 200 beds 

  • 88% of providers polled are eager to implement more sophisticated clinical documentation improvement tools that use artificial intelligence to boost the speed, accuracy and efficiency of coders. 

New platforms embed AI-powered clinical intelligence in both standard clinician and CDI workflows, analyzing EHR notes and clinical data to find gaps and deficiencies before notes are saved to the EHR.

“AI-enhanced CDI also allows providers to explore new opportunities with payers because hospitals have the data to show where quality outcomes are performing best,” said Doug Brown, President of Black Book. “Physicians are facing an increasing battery of measurements meant to drive quality, satisfaction and efficiency, but the complete and compliant evaluation and management coding is critical for physicians despite mixed reactions to measurements.”

The average case mix overall improvement in 128 hospitals surveyed between 150-400 beds accomplished an average $1.6M in financial improvements from AI-enhanced CDI initiatives form Q3 2018 to Q3 2019 as reported by the survey respondents.

“Improvement of clinical documentation provides the opportunity to maximize reimbursement and CDI is the process of enhancing medical data collection, improving quality of care while maximizing payer reimbursement income. It definitely maximized the revenue cycle efficiency,” said Brown.

Black Book conducts polls and surveys with healthcare executives and frontline users about their current technology and services partners and awards top-performing vendors based on performance on 18 indicators specific to innovation in solutions and services, product performance as well as client experience, loyalty and customer satisfaction.

Overall, 89% of all hospitals surveyed report cutting transcription costs in half or more while improving the transparency of dictation and transcription processes within one year of implementing end-to-end coding, CDI and transcription software tools. 94% of providers realized operational efficiencies without impacting clinician workflows. 

An impressive 90% of hospitals confirm documented quality improvements and increases in case mix index within six months of CDI implementation. The survey of hospital technology, financial and physician leaders found coding and clinical documentation improvements are now imperative.

83% of hospital financial officers claim that the biggest motivators for adopting additional CDI situations is to provide improvements in case mix index, resulting in increased revenues and the best possible utilization of high value specialists.

About Black Book

Black Book™, its founders, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the surveys it conducts including Nuance. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges, and/or vendor collaboration as Black Book polls vendors’ clients.

Since 2000, Black Book™ has polled vendor satisfaction across over thirty industries in the software/technology and managed services sectors around the globe. In 2009, Black Book began polling the client experience of now over 640,000 healthcare software and services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowd-sourced surveying to IT and health records professionals, physician practice administrators, nurses, financial leaders, executives and hospital information technology managers. Users participated in the 2019 polls of coding, CDI, transcription and speech recognition client experience in a sweeping seven-month set including eight separate studies.

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Source: Black Book Research