Treeland Healthcare System

Treeland Health System operates four hospitals and five other healthcare facilities. Serving patients for more than 60 years, the health system is an organization committed to delivering personalized healthcare. They use cutting edge medical technologies and continue to seek opportunities to increase technologically-driven processes. Treeland offers inpatient and outpatient services. Treeland Health System is experiencing a shortage of coders. In the recent years, there has been a 30% vacancy rate for coders throughout the hospitals and surrounding facilities. The shortage has caused issues with unbilled revenue, overtime, employee morale, overworked coders, and limited schedules. It is estimated that the annual loss is approximately $3 million per year. Applicants for the coding positions consistently declined because of their interest in flexibility and working from home.

The Challenge

Challenge

So, here's the challenge.

Due to the coding staff shortages, Treeland decided to temporarily utilize an outsourcing company to assist with the backlog.  The company has been used for the past four months. Outsourcing costs are currently estimated at $160,000 per year. Inpatient records are coded within 6 business days and outpatient records within 4 days. However, due to the volume of backlog, revenue loss is continuing to escalate. The organization would like to identify a long-term solution and implement within one year. The planning committee will meet to discuss potential solutions. 

Plan of Action

The Health Information Management Director has been assigned to lead the project due to its focus on coding functions. The director proposes a revised workflow and implementation of a software for home-based coding. The approach will support the need for home-based coders, fill vacant positions, and maintain organizational goals for outsourcing costs.

Key Indicators

The HIM Director defined two key indicators to help monitor the success of this project - outsourcing costs and coding workflow.

Outsourcing Costs

Outsourcing costs are currently estimated at $160,000 per year. Inpatient records are coded within 6 business days and outpatient records within 4 days. However, due to the volume of backlog, revenue loss is continuing to escalate

Coding Workflow

The Health Information Management (HIM) Director has been assigned to lead the project due to its focus on coding functions. The director proposes implementation to support a process, workflow, and software for home-based coding.  

True or False. Which of the following goals could be used to measure the progress of this project, as it pertains to challenges for coding and reimbursement?

  • Decrease outsource costs by 75%.
  • Increase coding staff vacancy rate by 5%.
  • Maintain coding productivity at 80%,
  • Decrease coding turn-around by 7 days.
  • Increase the number of charts denied for billing by 20%.
  • Hire two specialty coders.

Congrats!

You've completed the case.