Chartwise Medical Systems Scores Again with New RAF Calculator Debuting at AHIMA 2017
Oct 5, 2017 | VIA BLOG | Posted 4:39 PM by Dr. Jon Elion

ChartWise Medical Systems, Inc. (www.chartwisemed.com), the award-winning industry leader in Computer-Assisted Clinical Documentation Improvement (CACDI) software, plans to disrupt the coding and documentation industry at this year’s AHIMA Convention & Exhibit with the debut of the company’s new Risk Adjustment Factor (RAF) Calculator which has been developed to provide hospitals and medical systems unparalleled technology to measure and drive CDI processes.

For CACDI, the better a hospital or medical center can document HCCs, the higher the possible RAF scores and the higher the reimbursement.  While similar to Diagnosis-Related Groups (DRGs), RAF scores apply in the ambulatory setting as well as the inpatient setting, and that’s the best place for ambulatory CDI to focus their efforts.

ChartWise’s RAF Calculator puts hospitals and medical centers in the best possible position to assess and maintain an accurate patient risk profile which is imperative in today’s healthcare environment for a multitude of reasons, including:

  • Using Risk Adjustment to drive reimbursement started with Medicare Advantage plans, and is showing up in an increasing number of insurance plans
  • Risk Adjustment models predict health care costs of patients
  • The RAF for a patient has been difficult to calculate, and not generally available in a timely fashion
  • Real-time availability of the patient’s RAF score turns it into a valuable means to measure the impact of CDI, both inpatient and ambulatory
  • RAF scores provide healthcare facilities a solid Key Performance Indicator (KPI) to measure and drive ambulatory CDI success

“To date, CDI has focused on the inpatient population, using DRGs to determine reimbursement, and Severity of Illness (SOI) and Risk of Mortality (ROM) to identify how sick a patient is,” said Dr. Jon Elion, founder and CEO of ChartWise Medical Systems. “However, as the CDI industry begins to contemplate outpatient or ambulatory, different metrics are required. We cover both inpatient and ambulatory—providing both the DRG weight and RAF scores. This is truly a game-changer in the industry.”

ChartWise’s RAF Calculator is packed with innovative features, including:

  • An algorithm for calculating all of the current nine CMS and all of the 30 HHS Risk Adjustment models
  • RAF calculations for patients not currently enrolled in a RAF-based payer plan
  • RAF scores available for display and analysis at each stage of the CDI workflow
  • Functionality designed for a meaningful assessment of chronic conditions, in addition to the acute conditions already addressed by CDI

The 2017 AHIMA Convention takes place October 7-11 at the Los Angeles Convention Center and ChartWise will be on hand demonstrating their new RAF Calculator technology—along with a variety of additional advanced features contained within the company’s ChartWise 2.0 CACDI software solation—at booth 922 for the duration of the event.

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