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Catholic Health builds momentum for CDI excellence with early ROI success

Case study

Discover how unified training, integrated technology, and real-time insights improved quality and financial outcomes at six hospitals

A male doctor, wearing a lab coat and Littman stethescope, walks alongside and talks to a female admin holding a tablet.
About Catholic Health The challenges CDI transformation Education and training Data and insights Redesigning processes Contact us Solutions
On this page...
About Catholic Health
The challenges
CDI transformation
Education and training
Data and insights
Redesigning processes
Contact us
Solutions

Organization profile

Catholic Health

Catholic Health Long Island has been caring for Long Islanders for over 100 years, delivering exceptional clinical care. The organization is committed to becoming the premier health system on Long Island, transforming healthcare delivery through state-of-the-art, patient-centered care for every person, every time. The organization’s focus on innovative problem-solving enabled it to fully leverage Solventum’s solutions and tools, further enhancing its capabilities. This partnership’s success is a testament to the faith, compassion and innovation already embedded in Catholic Health’s approach to care.

6 acute care hospitals

A hospital building.

1,900 beds

A hospital bed.

86,000 admissions

A medical document.

3,650 physician partners

A patient and a doctor.

Challenges facing Catholic Health

Catholic Health faced barriers to achieving a high-performing clinical documentation integrity (CDI) program, including operational gaps and workflow inefficiencies. If a case was reviewed by CDI, coders were required to send the case back to CDI for final review and bill drop, which contributed to high discharged-not-final-billed (DNFB) rates and missed opportunities for collaboration with coders and education to make final decisions regarding final codes.

Coders also had no access to CDI findings, creating silos and inefficiencies. Their legacy encoder lacked key functions like auto-sequencing, patient safety indicator (PSI) and hospital-acquired complication (HAC) flagging and relied heavily on human memory and manual processes.

These challenges had downstream impacts. Severity of illness (SOI) and risk of mortality (ROM) metrics were underutilized, limiting Catholic Health’s ability to capture the complexity of its patient population. At the same time, provider engagement was inconsistent, leading to documentation gaps that weakened quality scores and reimbursement.

Contract signed | Project planning | Assessment chart review

July–Oct. 2023

A timeline with a clock hovering over points on a line.

Contract signed | Project planning | Assessment chart review

July–Oct. 2023

A timeline with a clock hovering over points on a line.

Partnership-driven CDI transformation

Catholic Health needed more than just new technology: It needed a more integrated approach, one that would promote collaboration, improve documentation quality and enhance financial outcomes. The health system sought a partner who could provide a comprehensive approach to CDI transformation, with a few non-negotiables:

  • Unified training and education program for CDI, coding, quality and provider teams
  • Seamless integration of CDI and coding on a single platform
  • Auto-sequencing and quality flagging to reduce PSI/HAC exclusions
  • Shared accountability and commitment to measurable goals
  • A clear, trusted pathway to ROI

Catholic Health’s strong foundation and open-minded teams partnered with Solventum launching a comprehensive consulting engagement anchored by Solventum ACT, Solventum PAS and Solventum PDM.

Building capability through education and training

Solventum ACT provided targeted education, workflow redesign and hands-on shadowing for CDI specialists, coders and providers. Physician-to-physician education improved engagement and query response, while project managers and solution advisors ensured sustained accountability. Training was unified across CDI, coding, quality and providers, aligning all teams around shared goals.

A person with graduation cap with arms lifted up in celebration.

Quality training | P2P training

Feb. 2024

A timeline with a clock hovering over points on a line.

Strengthened collaboration across CDI, coding, quality and providers

Proactive quality management through real-time PSI/HAC flagging

“We anticipated that it could take us up to a year to realize our return on investment due to the number of process changes required. We were surprised that within four months we were able to realize and exceed our shared accountability.”

Julie Kapoor
Senior vice president of revenue management and managed care, Catholic Health

A circle made up of repeating straight lines

May 2024

Solventum™ 360 Encompass™ go live

with Engage One Query delivery and Evidence sheets

A timeline with a clock hovering over points on a line.

Coverage rates improved from ~50% to over 90% across hospitals

Query rates improved for 4 of 6 facilities, with all exceeding best practice of 35%

Query response rates above 90%, with provider agreement rates over 98%

Driving accountability through data and insights

Solventum PDM gave Catholic Health visibility into its data and key financial and quality metrics, including case mix index (CMI), SOI, ROM and diagnosis related group (DRG) capture opportunities, using national benchmarks, peer groups and cohorts from client comparative benchmarks, to measure performance and uncover high-impact areas. The platform also equipped leaders with the ability to track progress, monitor improvements over time, and deliver clear reports to key stakeholders.

A line graph within a magnifying glass.

157% 

of ROI target for consulting services achieved in just 4 months

Aug. 2024

A confetti popper.
“Now, because of the education and software capability, we query for SOI and ROM impacting diagnoses, which has improved our statistics and quality scores. Our CMI has improved because we’re reviewing cases concurrently and querying the provider in real time, obtaining MCC and CCs where appropriate.”

Mary Mastrandrea
System director of CDI/DRG appeals, Catholic Health

A circle made up of repeating straight lines

Redesigning processes for efficiency and accuracy

Consultants worked with Catholic Health to restructure workflows and shift from retrospective to prospective review. Coders were empowered to drop bills once documentation met standards, reducing DNFB and accelerating revenue capture. Quality monitoring also shifted from reactive to real-time, using improved processes for PSI and HAC tracking.

A gear with a clock in the center.

456% 

of ROI target in year one

An arrow pointing upward.

Additional year one results:

$15.3M

in program impact

2.2%

increase in SOI

2.14%

increase in CMI

16.9%
improvement in ROM

A person with arrows continuously circling around them.

Building a foundation for continuous improvement

Catholic Health’s early success highlights the value of a consulting-led CDI transformation. With Solventum ACT and Solventum PDM, the organization quickly built a stronger, more collaborative program, achieved rapid ROI and laid the groundwork for sustained financial, quality and operational improvements.

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