Coding and reimbursement have become almost synonymous in the health care industry. Diagnostic Related Groups (DRGs) have been the standard for inpatient reimbursement for more than 30 years, with the Inpatient Classification of Diseases (ICD) a global system used for public health and policy purposes.
In the new era of pay-for-value, however, the type of care performed has become less important than the quality with which it was provided. Interestingly, there is a strong connection between accurate and complete coding and health care quality.
The latest featured topic for Optum®— “The Impact of Coding on Quality of Care” — discusses how finding and properly categorizing uncoded patients make a huge difference in quality of care and reimbursement. Through a select group of provider organizations known as the Anceta Collaborative, analyses of shared data is proving that coding missed diagnoses is huge.
In our next post, we will dig deeper into the data to see why the nature of a patient’s coding could affect the quality of the care they are receiving.
For more information, read the complete featured topic, “The Impact of Coding on Quality of Care.”
About the Author:
Carl Johnson, MD, EdM, MSc. is a pediatrician trained at Boston Children’s Hospital. He completed a Medical Education fellowship at Harvard Medical School and was a faculty health services researcher at The Mount Sinai School of Medicine.
Before joining Optum Analytics he worked as a physician executive at Cerner Corporation. He is a graduate of the Mount Sinai School of Medicine in New York City and has held faculty positions at Harvard Medical School, University of California at San Francisco, The Ohio State University, and The Mount Sinai School of Medicine.
Dr. Johnson believes that healthcare can be transformed with the help of the right data. When he is not helping to transform healthcare, he can be found playing tennis, cooking, perfecting his French, taking photographs, reading historical fiction, listening to music, and watching Ohio State Football.