CDI specialists play vital role in capturing pay-for-performance measures

March 11th, 2015

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is about the role of clinical documentation improvement in CMS pay-for-performance reporting. It discusses PSI 90, the hospital quality programs that use it, and the types of documentation, coding, and EHR-related considerations that affect claims-based quality measurement. It is relevant to CDI specialists, inpatient coders, quality departments, and hospital leaders involved in quality reporting and documentation improvement.

Why This Topic Matters

Accurate documentation and code capture can affect how hospitals perform in claims-based quality programs and how they are evaluated for hospital quality reporting. The article helps readers understand the broader operational importance of CDI within CMS measurement programs and EHR-supported documentation workflows.

Article Sections

  1. CDI role

    Introduces why CDI teams need to understand CMS pay-for-performance measures and how documentation quality affects claims-based reporting. It frames the article’s focus on hospital quality measurement and CDI involvement.

  2. Introduction to PSI 90

    Summarizes PSI 90, the organizations and programs associated with it, and the hospital reporting context in which it is used. It also outlines the broader structure of the composite measure.

  3. Get engaged in PSI 90 data quality improvement

    Describes high-level CDI and quality department collaboration steps for improving reporting performance. The section emphasizes organizational engagement and documentation improvement planning.

  4. Identify PSI coding and documentation vulnerabilities

    Explains the major measure concepts used to evaluate PSI-related coding and documentation, including measure inputs and risk adjustment. It focuses on how CDI teams review vulnerability areas across the measure structure.

  5. Leverage your EHR to improve documentation capture

    Discusses how EHR workflows can support more consistent capture of clinically important information for quality reporting. It highlights coordination among CDI, clinical, and IT stakeholders.

  6. Coming up

    Provides a brief preview of the next article in the series and the general topic areas it will address. It also indicates that the discussion will continue with additional PSI-related guidance.

What You Will Learn

  • How CDI teams contribute to CMS quality reporting and claims-based measurement
  • What PSI 90 is and how it fits into hospital quality programs
  • How documentation and coding workflows can influence data quality for PSI-related reporting
  • How hospitals can think about measure structure, documentation capture, and EHR support in a quality-improvement context
  • Why collaboration between CDI, quality, clinical staff, and IT matters for reporting accuracy

Who Should Read This

  • Clinical documentation improvement specialists
  • Inpatient coders
  • Hospital quality staff
  • Revenue cycle and compliance teams
  • Health information management professionals
  • Clinical leaders involved in documentation workflows

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