Healthcare providers are increasingly accepting financial risk associated with patient management.

A CDI program that covers both hospital inpatient and ambulatory settings helps improve the accuracy of risk scores while mitigating the impact associated with inaccurate coding.

Accurate clinical documentation, medical coding and reporting enhance data integrity and value-based quality outcomes, supporting key performance programs across the continuum.

  • Merit Based Incentive System (MIPS)
  • Alternate Payment Models (APM)
    • Accountable Care Organizations (ACOs)
    • Bundled Payment Models
  • Annual Medicare Advantage Capitation Rate
  • Hospital Value-Based Purchasing (VBP) Program
  • Hospital Readmission Reduction Program (HRRP)

Enjoin helps clients set clear CDI goals in the ambulatory setting so you know where to start, and what to expect in physician practices, physician clinics, and hospital outpatient services. By focusing on your specific education needs, we ensure an accurate Risk Adjustment Factor (RAF) score, capture of Hierarchical Condition Category (HCCs), quality performance and reimbursement.

For risk adjusted payment methodologies that use Hierarchical Condition Category (HCCs) the purpose is to promote fair provider payments that reward efficiency and encourage quality of care for the chronically ill patient population. These also determine incentives and penalties associated with other value based initiatives (VBM, MSPB, ACO, etc.). By focusing on comprehensive risk-adjustment, we ensure the data integrity that’s necessary to effectively drive population health management.

Benefits of Enjoin’s Ambulatory CDI Program: 

  • Customized program and workflow processes to optimize impact
  • Immediate results with physician integration
  • Long term success with care team education and physician engagement
  • Strengthened documentation infrastructure to promote and support the capture of essential documentation at point of care
  • Reduction of audit risks and/or denials

5 components for a successful ambulatory CDI program

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