Case Study: CommuniCare Health Services recovers $10M in PDPM revenue with Digital Scientists' AI-powered MDS optimization

CommuniCare Health Services recovers $10M in PDPM revenue with Digital Scientists

CommuniCare Health Services, one of the nation's largest post-acute care providers, faced significant revenue leakage and quality score issues due to incomplete MDS assessments. Manual reviews were taking 3-4 hours per resident, leading to uncaptured diagnoses that directly impacted PDPM reimbursement. Digital Scientists was engaged to address this challenge with an AI-powered MDS optimization solution.

Digital Scientists built an AI-powered coding engine that integrated with PointClickCare to ingest data from multiple clinical sources. The solution surfaced uncaptured diagnoses with confidence scoring and cut review time from hours to roughly 60 seconds per patient. The implementation recovered $10M in PDPM revenue, generated $2M in annual quality incentives, and achieved a 40-60% time savings per assessment for MDS coordinators.

CommuniCare Health Services