$17.1M in additional annualized reimbursement, a 57% increase in code capture at Jackson Health, and a second solution now live.
Two patients are admitted for pneumonia. Same age, same risk profile on paper. One goes home in five days. The other stays longer and is readmitted within the month.
The difference was in the chart the whole time. Months of weight trends, labs, and clinical notes pointing at malnutrition, scattered across the record while the care team focused on the acute problem that brought the patient in.
That gap is why we launched the Care Gap and Coding Automation Suite in February. Six months later, here is what the health systems running it have reported.
The results
Across clients, Malnutrition Care Automation has captured $17.1M in additional annualized reimbursement.
- Jackson Health System, the first client live on the solution, increased malnutrition code capture by 57% and is realizing 3.3x annualized ROI
- A midwestern academic medical center reported a 15% lift in code capture alongside improvement in its mortality O:E ratio
- An Ohio-based nonprofit health system reduced time to nutrition care for malnourished patients by 2.5 days
- A Wisconsin-based system reports that patients coded for malnutrition experiencing a 0.6-day reduction in length of stay
- Another Wisconsin-based system achieved a 14% increase in code capture at one of its hospitals
“By leveraging the Malnutrition Care Automation solution, we’re identifying at-risk patients earlier than traditional screening methods alone, allowing our caregivers to intervene sooner and improve outcomes. Our partnership with Qventus, coupled with its AI-assisted capabilities, has allowed us to quickly extend this capability across our clinical operations, supporting our mission to deliver the right care at the right time for the patients that depend on us.” — Monica Puga, Chief Transformation Officer, Jackson Health System
Why timing changes the outcome
Severe malnutrition is chronic, highly treatable, and routinely missed. Patients with the condition typically stay two additional days and face twice the readmission risk.
Providers are trained to treat the acute problem first, and they should be. That is also the reason a condition like malnutrition goes unaddressed while the team manages the pneumonia in front of them.
Conventional CDI compounds the problem by working through a rearview mirror. Charts get audited 24 to 48 hours after care, once the window for intervention has already closed. What is left to fix at that point is the documentation, not the patient’s course.
Malnutrition Care Automation moves recognition to the front of the stay. The Care Gap Assistant mines structured and unstructured data across the chart to identify at-risk patients in real time, catching cases that manual screening routinely misses. The nutrition consult order is pre-populated in the EHR for a provider to sign. The Coding and Documentation Assistant then prompts diagnosis documentation for MCC/CC capture before the coding window closes.
The dietitian walks into the room with the picture already assembled, on a patient who might not have been identified at all. And because each diagnosis is backed by care that was actually delivered, the coding holds up under payor audit.
“Providers are trained to treat the acute problem first. Conditions like malnutrition and pressure injuries get treated late or not at all, and the patient goes home sicker than they needed to. This suite moves recognition and intervention to the front of the stay, when treating the condition can still shorten length of stay and lower readmission risk. It also means providers aren’t answering CDI queries about that patient a week later, when they’re already caring for someone else.” — Jason Cohen, MD, Chief Medical Officer for Inpatient, Qventus
Pressure injuries are next
Today we launched Pressure Injury Automation, the second solution in the suite.
It continuously analyzes patient data to identify patients at elevated risk and orchestrates the next clinical action, including initiating prevention order sets, recommending support surfaces, prompting timely skin assessments, and confirming that repositioning interventions are completed. Documentation follows the same path, capturing skin assessment findings, present-on-admission status, prevention activities, and pressure injury staging as care is delivered rather than after discharge.
Present-on-admission accuracy carries particular weight here. An injury documented during the admission window is recorded as present on admission. The same injury captured later is counted as hospital-acquired, which affects performance under the CMS Hospital-Acquired Condition Reduction Program. Getting the timing right is a quality and compliance question before it is a reimbursement one.
Why the second solution took six months instead of years
New solutions in the suite inherit the platform underneath: bidirectional EHR integrations built over a decade, AI assistants already running identification through documentation, and orchestration that holds across care settings. A new condition does not start from scratch.
That is what makes expansion a configuration decision rather than a new implementation. Health systems already running Qventus add new use cases and care settings without another vendor, another integration, or another implementation cycle.
Seventy-two percent of health system AI leaders say they would prefer one comprehensive AI partner managing multiple use cases rather than assembling point solutions. Velocity is what turns that preference into something a health system can actually act on.
“Qventus set a new record this year. We launched the Care Gap and Coding Automation Suite with the first automation in February, and today we’re announcing ROI across clients and releasing the second solution in the suite. Health systems want to consolidate around a single AI platform, and making it easier to turn on new solutions is how that becomes real. This team can build at a velocity that helps our clients secure the margins they need to deliver exceptional care.” — Mudit Garg, Co-founder and CEO, Qventus
What comes after pressure injuries
Malnutrition and pressure injuries are two conditions that follow the same pattern: present in the patient, visible in the chart, and missed while the care team manages something more acute. The same system of action extends to delirium, acute kidney injury, encephalopathy, and other complex conditions hiding in plain sight across the record.
Contact us to see how the Care Gap and Coding Automation Suite can work in your environment.
