It’s as much about the game as it is the bedside.
Hospitals across the country work tirelessly to deliver high-quality care, but when it comes to published quality ratings, the story told often doesn’t match the work done at the bedside.
At Tendo, we hear this all the time. That’s because ratings systems rely heavily on documentation and risk-adjusted metrics, not just the clinical outcomes. If something isn’t documented, it’s as if it never happened. And that has big consequences.
The Misalignment Between Documentation and Quality
Let’s take a common scenario: a patient with COPD is readmitted, and they also suffer from major depression. If major depression isn’t documented, it won’t affect reimbursement, but it will throw off your Observed-to-Expected (O:E) ratio. The same applies to a joint replacement patient with obesity. Miss that in the chart, and your readmission risk model takes a hit.
And that’s just the beginning.
Tools Optimized for Billing, Not Quality
Clinical Documentation Improvement (CDI) tools and coding platforms are often built to surface financial opportunity, not to support accuracy in quality reporting. Coders are maximizing the bill. CDIs are chasing revenue. But quality ratings? That’s a different game, and most teams don’t even have the rulebook.
Risk Models Are Evolving—Can Your Teams Keep Up?
Risk models change every year—the weight of comorbidities shifts. Yet most providers, CDIs, and coders aren’t trained on these models, let alone on how to document for them. This knowledge gap can tank a hospital’s public ratings—even when clinical care is excellent.
Playing Chess with Checkers Pieces
We like to say: “It’s a chess game, but your players and their tools have been trained on checkers.”
To win this game, health systems need better visibility, smarter tools, and alignment between financial and quality objectives. That’s exactly where Tendo Insights comes in.
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