Will POA reporting improve quality of care?

An article in the Dec. 26 issue of For the Record suggests that while reporting the POA indicator will initially create some challenges for the industry, it may also create opportunities to improve care quality by:

• Adding precision to ICD-9-CM coding, enabling organizations to distinguish between pre-existing conditions and complications.
• Increasing the efficiency and effectiveness of hospital quality assurance activities.
• Improving the accuracy of mortality risk assessment and outcomes research.

The initial challenges, according to the article, include dealing with decreases in coder productivity. States that have had POA-like policies in place (New York, California, Florida, Massachusetts and Maryland), all reported coder productivity decreases in the months following POA implementation.

Other challenges include the need for hospitals to change policies in order to identify POA conditions when patients are admitted, and implementing preventive measures to minimize hospital-acquired conditions, the article stated.

The big question, however, is how CMS will respond to certain POA indicators during audits. Besides the Y (yes) or N (no) POA indicator, CMS allows a U (for unknown) or W (for clinically undetermined) on claims. As of yet, the industry is unclear how CMS will react to the Ws or Us during audits.

Access the full article here.