Benefits

Qi (氣) is the Chinese word for “energy flow”. When trauma centers face high workload and patients with unfamiliar conditions, the flow of patient care and documentation can get rushed, potentially resulting in omissions, errors, and lower reimbursement. TraumaQi™ is a quality improvement program that detects and corrects these situations, offering the following benefits:

• Increases trauma center revenue by up to $20,000 per claim
• Focuses quality improvement efforts on the claims where quality has the greatest impact on revenue
• Reduces legal liability caused by lower-quality work produced under fatigue

Magnitude of the Claims Quality Problem

In one academic medical center we examined, the trauma center’s 60 most problematic claims each year were causing it to lose $400,000 in revenue per year – roughly $7,000 per claim. This can and should be prevented. A more holistic version of our quality control initiative could have prevented it from losing over $700,000 per year – roughly $1,000 per claim. As you know, patients with less documentation are less likely to receive high-severity DRG assignments, regardless of their actual severity. The difference between the reimbursement between the two is rather stark; high-severity DRG assignments produced 28% more revenue than low-severity assignments in the hospital previously mentioned. TraumaQi™ is the simple, powerful, and rigorous solution for improving the quality of trauma claims.