A programme to improve the quality of coding data has led to more than £1.1m in additional income being identified for a south London trust
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Maxwell Stanley has worked with a south London trust to achieve high standards of clinical documentation and coding accuracy, in order to ensure that activity complexity is accurate for current and future payment decisions and to improve the trust’s financial position.
Requirement
The trust provides healthcare services to more than 1 million people across south east London. They approached Maxwell Stanley to request assistance with the quality of their coding data, as they felt that the complexity of activity was not being accurately captured. This was having an impact on in-month elective activity income claims and the accuracy of wider future financial contract baselines and in-year negotiations, following the part-return to income paid through a “payment by results” model when the NHS Pricing Scheme 2023-24 was introduced.
Project objectives
- Identify additional income that had been missed due to inaccurate coding.
- Improve clinical coding depth to be closer to the national average.
- Increase the accuracy of activity complexity.
- Improve processes to ensure greater coding accuracy moving forward.
Solution
Using the Maxwell Stanley solution, a comprehensive suite of rules was auto applied to validate the trust’s coded activity data, identifying specific admissions in which complexity and tariff income was routinely being inaccurately reported due to inconsistent documentation and inaccurate coding. These are identified through missed chronic comorbidities, and a suite of quality assurance coding rules.
Outcome
- More than £1,135,000 in additional HRG income in four months.
- Average coding depth already increased from 3.7 to 3.9 for elective and 4.3 to 4.4 for non-elective admissions.
- Increased clinician awareness of their documentation responsibilities to facilitate accurate clinical coding.
The trust’s deputy director of IT said: “We knew that there was potential in our data; the introduction of block contract funding during covid, which also introduced home working for many of our teams, led to a reduction in the accuracy of our coding. Maxwell Stanley have not only identified an incredible amount of additional income, but also improved our published coding depth figures. In just four months!”
