Tonya Motsinger: Surviving and thriving in an evolving CDI landscape

Listen to the episode here: https://spotifyanchor-web.app.link/e/c6FFYxoXZMb    With 25 years’ experience in medical/surgical, critical care, and emergency department medicine, Tonya Motsinger has seen her share of crises.  COVID-19 was a crisis of a far larger scale. The pandemic wreaked havoc not only on patients, but her CDI department, resulting in staff shortages. Today OhioHealth’s System…

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The ROI of Staffing—How one organization made the case

High-quality coding and CDI professionals are costly. Labor expenses as a whole comprise over 50% of a facility’s expenses. But strategic staffing can actually boost your ROI. One of our partners saw a significant return by optimizing coverage rates. Download the full article and uncover the secrets to maximizing your staffing investment.

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Bridging divides: Leif Laframboise on merging the clinical and financial through data

Listen to the episode here: https://spotifyanchor-web.app.link/e/n2tsZSPmCMb Bridging the gap between clinical and financial worlds is the goal of CDI and coding, but it’s much easier said than done. One way to reconcile this schism is through data—objective numbers that don’t lie, but can speak to both sides of this seemingly irreconcilable chasm. Associate Director of…

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Norwood MS-DRG audit results in substantial DNFB reduction, missed revenue opportunities

Even with the rapid growth of risk adjusted payments, Medicare Severity DRGs (MS-DRGs) remain the principal reimbursement mechanism for most healthcare organizations.   But despite their relative maturity there is always room to improve MS-DRG assignment. Missed complications/comorbidities (CC) and major CCs, inaccurate principal diagnosis assignment, and non-specific/symptom DRGs lead to underreported severity of illness.…

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New CMS claims-based surgical quality measure is in effect; are you ready?

By Brian Murphy   In the 2025 IPPS final rule CMS finalized its proposal to replace PSI-4 (Death Rate Among Surgical Inpatients with Serious Treatable Complications) with a new claims-based measure: The Thirty-day Risk-Standardized Death Rate among Surgical Inpatients with Complications (Failure-to-Rescue).   In fact, this change has already taken place.   This new measure…

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Moving up and leaving behind: Robin Jones on growing into leadership

Listen to the episode here: https://open.spotify.com/episode/6I6v7JrBwt8Xf73RfWmBGF?si=cHXeDeKeSWiZoyLfyoh5Ag Robin Jones moved to Florida at the tail end of 2017 to pursue a burgeoning career in CDI. And ever since has done nothing but climb the professional ladder. Leaving behind her home in Cincinatti Ohio and a decorated career in CDI at Mercy Health, Robin started over as…

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OIG report on mechanical ventilation raises compliance red flags

By Brian Murphy   Medicare improperly paid hospitals an estimated $79 million for patients who received mechanical ventilation.   Is your healthcare organization among them?   The OIG released a new report taking aim at MS-DRGs 207 and 870. It selected for review a random, stratified sample of 250 claims submitted between 2015-2021 with payments…

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