Systems & Strategy
UM & CDI Value Equation Quick Reference (O’Brien, SHM 2024) 🔗
Purpose: Align utilization management (UM) and clinical documentation integrity (CDI) to improve hospital value = quality / cost. ⚙️ Core Formula 🔗 Value = Quality / Cost
Improve documentation and utilization → reduce LOS gap → accurate payment & fair benchmarks. 🏥 Key Metrics 🔗 MetricDefinitionGoal / ImpactALOSActual average inpatient stay≤ GMLOS; optimize throughputGMLOSGeometric mean LOS per DRGBenchmark for case complexityCMICase Mix
Antonio E Smith