CASE STUDY: Documenting TAVR co-morbidities
California Hospital finds that accurate documentation improves care, boosts TAVR reputation, and generates appropriate reimbursement When implementing a Transcatheter Aortic Valve Replacement (TAVR) program, it is essential to implement a system for accurately charting and coding patient co-morbidities. This will result both in improved patient care and accurate Medicare submissions. First and foremost, the adoption of best practice solutions to document patient co-morbidities improves care continuity for patients. When multiple providers care for the same patient, an accurate patient chart reduces both redundancy of care and missed opportunities for best care. Secondarily, a TAVR program may become difficult to sustain if patient co-morbidities are not charted and coded with accuracy. This is because different patient co-morbidities trigger different Medicare reimbursement codes to ensure that patients are receiving necessary and appropriate care. TAVR programs that capture appropriate co-morbidities have the potential to sustain themselves on two levels: 1. Thorough documentation sets patients up for better care and outcomes. This success, in turn, will inspire confidence in prospective TAVR patients that your hospital’s track record is one that can be trusted. 2. Thorough documentation ensures accurate Medicare filings and reimbursement.
Both of these factors are crucial for the long-term viability of a TAVR program that offers a successful treatment for high-risk severe aortic stenosis patients who previously only had open-heart valve replacement or palliative care options. This case study describes the process implemented by a California hospital that began offering TAVR in 2014 to appropriately document TAVR patient co-morbidities. Overview This case study hospital started its TAVR program in August 2014 and performed nearly 30 TAVRs in the first year. While hospital administration projected a loss of $400,000 in the TAVR program’s first year, the program actually realized a small amount of profitability due, in part, to precise and thorough documentation, according to hospital officials.. “It’s done better out of the gate than we thought it would,” says the heart and vascular services director. We are much closer to break-even than we thought we’d be. In fact we realized a small profit.” Patient Care and Outcomes Interdisciplinary Structural Heart meetings are held at 7 a.m. every Monday. Care providers come together for in-depth discussion on the health status of every patient “Our group takes a look at all the documented comorbidities, and we discuss the real person who’s inside all of that,” the director says.