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Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
Performance indicators differ from business drivers and aims (or goals). A school might consider the failure rate of its students as a key performance indicator which might help the school understand its position in the educational community, whereas a business might consider the percentage of income from returning customers as a potential KPI.
As more diagnostic tests have come online, the rate of “confirmed cases” — the key performance indicator (KPI) being monitored by decision-makers across the country — continues to accelerate.
Avedis Donabedian, a physician and health services researcher at the University of Michigan, developed the original model in 1966. [3] While there are other quality of care frameworks, including the World Health Organization (WHO)-Recommended Quality of Care Framework and the Bamako Initiative , the Donabedian model continues to be the dominant ...
The Physician Quality Reporting System ... It is an example of a "pay for performance" program which rewards providers financially for reporting healthcare quality ...
Key performance indicator—a method for choosing important/critical performance measures, usually in an organisational context Performance prism—a second-generation performance measurement framework used by organizations to manage performance by considering the needs and contributions of all stakeholders, not just shareholders and customers.
Stage 4: Compare performance with criteria and standards This is the analysis stage, whereby the results of the data collection are compared with criteria and standards. The end stage of analysis is concluding how well the standards were met and, if applicable, identifying reasons why the standards weren't met in all cases.