Clinical Documentation Improvement Heats Up as Half of US Hospitals Make 2015 Preparations for ICD-10, the Rest to Rely on Outsourcers, Black Book Survey Reveals

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Despite lost momentum, 51 percent of US hospitals report they will be ready to implement ICD-10 with coding education, IT solutions, managed services partners, staff training and physician cooperation. The other half intend to wait until next year to implement outsource technology and clinical documentation improvement (CDI) programs in a near-deadline effort to optimize reimbursement in the new code set era.


There is no bigger provider opportunity on the horizon to maximize financial health than to improve the accuracy of provider clinical documentation.

Outsourced coding and Clinical Documentation Improvement initiatives indicate signs of tripling in the number of hospitals contracting for external CDI services help before the October 1, 2015 deadline, according to the recently published Black Book™ survey of 650 hospital technology and physician leaders, found in the reports “Top Ranked Clinical Documentation Improvement Vendors”.

24 percent of hospitals now outsource Clinical documentation audit, review and programming. By Q3 2015, 71 percent of hospitals plan on having a CDI services partner help them adjust and survive under the new codes.

“There is no bigger provider opportunity on the horizon to maximize financial health than to improve the accuracy of provider clinical documentation,” said Doug Brown, Managing Partner of Black Book™.

88 percent of 200+ bed hospitals outsourcing CDI currently report to have realized significant (over $1M) gains in appropriate revenue and proper reimbursements following the implementation of clinical documentation improvement program yet before ICD-10.

Additionally, 83 percent confirm quality improvements and increases in the case mix index.

28 percent of hospitals presently outsourcing coding and CDI are contemplating a switch to second generation CDI vendors as physician practice acquisitions and EHR implementations have threatened the sustainability or effectiveness of their current CDI programming.

Nuance Communications ranked with the highest client experience and customer satisfaction scores on eighteen key performance indicators among currently implemented end-to-end CDI clients. Other top scoring vendors included 3M, Optum, The Advisory Board, Navigant, Chartwise Medical, Precyse and DCBA.

Transcription services, already outsourced by 63 percent of hospitals, is also expected to grow to over 70 percent of providers as the ICD-10 deadline approaches. The top ranked vendor in client experience and satisfaction of outsourced transcription services is Precyse.

Additionally identified in the functional subsets of coding-related services, Streamline Health ranked first in Content Management and Abstracting services.

According to the survey responses, 19 percent of all hospitals confirm they are outsourcing coding already. However, by the new code deadline, that number is anticipated to grow to 47 percent of hospitals by the providers polled. 3M ranked first in Computer-Assisted Coding (CAC) services.

“Transitioning to ICD-10 is a complicated process and hospitals are leaning on the expertise and successes of outsourcing vendors,” said Brown. “We still operate in an ICD-9 world, complicated by EHR implementations, value-based reimbursement models, compliance issues and optimizing reimbursement; a perfect storm from which outsourcers have the expertise to shield their clients.’

About Black Book™
Black Book Rankings, a division of Black Book Market Research LLC, provides healthcare IT users, media, investors, analysts, quality minded vendors, and prospective software system buyers, pharmaceutical manufacturers, and other interested sectors of the financial and clinical technology industries with comprehensive comparison data of the industry's top respected and competitively performing technology, services and outsourcing vendors.

The largest user opinion poll of its kind in healthcare IT and managed services, Black Book™ collects over 400,000 viewpoints on information technology and outsourced services vendor performance annually.

For methodology, auditing, resources, comprehensive research and ranking data, see

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Douglas Brown (Tampa FL)

Taylor Brown (Raleigh NC)
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