Case Study: Middle Star Health Care achieves expanded CDI scope and 55%+ coding productivity with Optum360

How a health system reached 99% physician response rate

Middle Star Health Care, an 850‑bed, four‑hospital health system serving a large Midwestern metro area, needed to transform its clinical documentation improvement (CDI) and coding operations to capture patient complexity, boost productivity and improve physician engagement. To do this it partnered with Optum360 and adopted the Optum Enterprise Computer‑Assisted Coding (CAC) and Optum CDI 3D platform (plus an Optum On‑Site Physician Advisor) to address documentation gaps, manual workflows and limited reporting.

Optum360 delivered a shared NLP‑driven CAC and CDI platform, automated workflows and performance analyst support that expanded CDI scope, increased collaboration and streamlined processes. The program drove measurable gains: diagnostic coding productivity +57%, inpatient coding +55%, ED/clinical coding +17%, a 4% increase in all‑payer CMI, 46% CC/MCC capture rate, 99% physician query response rate, 100% CDI review coverage at three facilities, a 62% peer‑to‑peer overturn rate and a 34% increase in physician advisor responses.