Physician-governed AI model delivering $13.3M annually for Sharp HealthCare
The Accuity partnership went live in just 51 days and increased Case Mix Index (CMI) by 2.4%.
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About Sharp HealthCare
Sharp HealthCare is an integrated, not-for-profit health system, serving San Diego County and surrounding communities. With five acute care hospitals, approximately 20,000 employees, and 2,700 affiliated physicians, Sharp HealthCare reported $3.76 billion in net patient revenue for its hospital division.
The challenge
As payer scrutiny intensified and DRG complexity grew, Sharp HealthCare saw the gap widening between the care it delivered and the reimbursement it captured:
- Growing payer volume and DRG complexity straining existing CDI resources
- Downgrades and retrospective reviews directly impacting reimbursement
- Need to improve DRG accuracy and documentation integrity across five hospitals
- Desire to strengthen internal alignment between physician leadership and CDI teams
- Strategic priority to ensure charts fully reflect clinical reality before billing
The results
Accuity’s physician-governed AI model reviews charts across all five of Sharp HealthCare’s acute care hospitals, ensuring every record fully reflects the clinical reality of care delivered. DRG accuracy is improved system-wide, defensibility of claims is reinforced, and vulnerability to retrospective downgrades are reduced.
Targeted, trend-based education on complex criteria such as sepsis and MI Type 2 is driving upstream documentation improvement, positioning Sharp HealthCare to navigate payer scrutiny with greater precision. Leadership engagement drove adoption across the medical staff, and CC/MCC capture rate has improved by 4.65%.
Accuity impact for Sharp HealthCare
- $13.3M Annualized net cash benefit
- 2.4% CMI improvement on charts reviewed by Accuity
- 4.65% CC/MCC capture rate improvement
- 51 days Implementation timeline
From contract to results in just two months
Pre-go-live alignment calls created a consistent forum for workflow refinement and trend-based education on complex criteria such as sepsis and MI Type 2. Sharp HealthCare’s leadership engagement drove adoption across the medical staff, and the program launched to a strong start driven by communication and collaboration.
Implementation was completed in 51 days, nine days ahead of schedule, with seamless integration into Sharp HealthCare’s existing workflows. The model added no burden to Sharp HealthCare’s internal teams, with a structured governance framework ensuring clear accountability and escalation pathways.
“Accuity's results have exceeded projections, and their peer-to-peer approach strengthened alignment between our physician leadership and CDI teams in ways we hadn't anticipated.”