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Case study

Mary Greeley Medical Center partnered with Solventum to transform its CDI program, improving physician engagement, documentation quality, and measurable financial and quality outcomes.

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Organization profile

The health system faced increasing patient volumes and a need to optimize its coding operations without expanding its full-time employee (FTE) base. Coders were spending time on repetitive tasks rather than applying their expertise, especially for simpler cases like ancillary services. At the same time, the health system observed that payer reimbursement rates were not keeping pace with inflation and rising operational expenses, adding financial pressure to improve efficiency. The organization sought a solution that could streamline coding, reduce manual effort and maintain accuracy.

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Challenge: gaps and fragmentation

Despite its strong clinical reputation, MGMC’s leadership identified several performance gaps tied to clinical documentation integrity (CDI). The organization struggled with:

  • Higher-than-expected length of stay (LOS) statistics compared to peers
  • Lower case mix index (CMI) relative to Centers for Medicare & Medicaid Services (CMS) and Iowa Hospital Association benchmarks

Extended LOS strained resources, staffing, supplies and beds, while reducing throughput and increasing operational costs. At the same time, documentation gaps limited the capture of severity of illness (SOI) and risk of mortality (ROM), impacting both financial performance and quality reporting. Further complicating matters, MGMC’s CDI program, although several years in, had become stagnant and outgrew its third party application. The program was also experiencing high staff turnover and fragmented workflows.

March–April 2024

  • Contract signed
  • Project planning
  • Kickoff
     

May–July 2024

  • Assessment chart review
  • Deep dive implementation methodology review
  • Assessment findings
     

August–October 2024

  • P2P training
  • Implementation training
  • Quality training
  • Shared accountability minimum financial objective met
     

January 2025

  • Solventum™ 360 Encompass™ go live
     

April 2025

  • Post Solventum 360 Encompass shadowing
     

July 2025

  • Solventum Summit award winner
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Solution

To address these issues, leadership sought a partner to:

Build a comprehensive, sustainable CDI program

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Align teams across CDI, coding and quality

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Provide integrated training for staff and providers

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Create measurable financial and quality outcomes

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Offer a clear path to ROI, reinforced by shared accountability

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Process, timeline and impact

Developing distinctive CDI

MGMC partnered with Solventum to launch a five-year engagement plan centered on the Solventum ACT program. Supported by Solventum 360 Encompass, Solventum PDM and Solventum PAS, the strategy focused on building CDI excellence and empowering program transformation.

Coverage expansion

+15%
Medicare/Managed Medicare

+34%
Other payers

Query rate increase

+15%
Medicare/Managed Medicare

+34%
Other payers

$1,126,969

Total program financial impact

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Technology and data insights

Implementing Solventum 360 Encompass created a unified foundation for CDI and coding, enabling concurrent reviews and real-time documentation optimization. Solventum PDM delivered timely visibility into case mix index (CMI), SOI/ROM, and diagnosis related group (DRG) capture opportunities, empowering MGMC to benchmark against national and peer groups and cohorts using Solventum™ Client Comparative Benchmarks, while surfacing missed financial and quality opportunities.

MS-DRG change

+2.97%
Medicare/Managed Medicare

+1.99%
Other payers

CC/MCC net new financials

+$678,921
Medicare/Managed Medicare

+$1,262,049
Other payers

SOI increased by 0.9% in other payers

ROM improved by 83% in Medicare/Managed Medicare populations

Process redesign and staffing changes

Solventum consultants partnered with MGMC leadership to reframe CDI operations. The department experienced some turnover when one clinical documentation specialist (CDS) retired and two others received promotions. To fill the gap, they hired one CDS but still had two open positions. MGMC went from the CDSs reporting to the quality team to three CDSs reporting into HIM, ensuring stronger alignment with coding. Workflows were redesigned to emphasize shared accountability, with ongoing reporting and mortality review processes built-in to sustain progress.

Physician response rate: Maintained above 90% across all payers

Physician agreement rate: Maintained above 90% for Medicare/Managed Medicare

Building capability through education

Education and training were the cornerstone of MGMC’s transformation, with new staff creating a great opportunity to revamp the CDI program.

Provider participation is responsible for 75% of admissions. Beating the 70% Solventum best-practice benchmark.

A physician champion was also appointed, supported by the CFO and physician leadership, to drive home the importance and benefits of physician participation.

Solventum provided:

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Chart-based training

A 100-chart review identified documentation gaps, which informed the development of a tailored training plan addressing those areas of improvement.

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Physician engagement

Solventum introduced physician-to-physician (P2P) education, pairing physician consultants with peers to deliver specialty-specific guidance using real MGMC cases.

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Inpatient CDI and coding education

Two weeks of interactive, major diagnostic category (MDC) based training with specific condition and case examples, aligned CDI and coding staff.

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Follow-up training

Regular 25-chart reviews reinforced lessons learned and created an ongoing cycle of education and accountability.

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Quality education

A focused week of quality education covering value-based purchasing, HACs, PSIs, PPRs/PPCs, HCCs, and proper patient placement for CDI, coding, and quality teams.

Conclusion

The MGMC journey illustrates how technology, process and education can combine to create lasting CDI transformation. By partnering with Solventum and implementing the Solventum ACT program, MGMC not only addressed immediate challenges but also built a sustainable framework for continuous improvement.

This partnership underscores a key truth: Meaningful CDI improvement requires more than software. It takes consulting expertise, CDI and coding team buy-in and commitment, provider engagement and shared accountability to achieve results that are financially impactful, clinically meaningful and operationally sustainable.

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Transform your CDI program with confidence

See how the right combination of technology, expertise, and shared accountability can drive measurable quality and financial improvement—just as it did for Mary Greeley Medical Center.