A new year invites vague goals. Improve accuracy. Increase reimbursement. Reduce errors. None of that is wrong exactly, but none of it is specific enough to actually act on either. The agencies that make real progress on case mix and reimbursement over a year are the ones who turn those vague intentions into a few concrete, measurable targets before the year even starts.

Here's how to actually build goals worth tracking.

Start with your own data, not an industry benchmark

Before setting any goal, get a clear read on where your agency actually stands right now. Pull your accuracy numbers by service line, your case mix distribution, and your comorbidity adjustment capture rate over the past several months. A goal built on an industry average means little if you don't know your own starting point, and the specific gap between where you are and where you want to be is what actually shapes a useful goal.

This step gets skipped more often than it should, usually because it feels like a delay before the "real" goal-setting work begins. In practice, it's the part that determines whether the goals that follow are realistic or just optimistic guesses. An agency that skips this step tends to set goals based on where they assume they stand, which is a different thing entirely from where the data actually shows they stand.

We publish our own accuracy numbers every quarter specifically because we think agencies benefit from having a real benchmark to compare against, not just a vague sense of "pretty good" or "needs work". Whether or not you use our numbers specifically, the principle holds: know your real starting point before setting a target.

Pick specific levers, not general categories

"Improve case mix" is a category, not a goal. A specific lever might be: capture comorbidity adjustments more consistently on charts with two or more chronic conditions, or reduce unspecified diagnosis coding on your ten most common conditions by a defined amount. These are targets you can actually measure progress against month to month, rather than a general sense of improvement that's hard to track and even harder to know when you've achieved.

Pick two or three specific levers rather than trying to improve everything simultaneously. A focused effort on a few real gaps tends to produce more actual movement than a scattered effort across everything at once.

Make sure your goals don't quietly work against each other

It's worth checking whether the specific goals you've picked actually reinforce each other or accidentally pull in different directions. A goal focused purely on reducing coding turnaround time, for example, can create pressure that works against a goal focused on coding specificity, since specificity often takes a bit more time to get right on complex charts. Neither goal is wrong on its own, but pursuing both without acknowledging the tension between them tends to produce quiet compromises nobody explicitly decided on.

The fix isn't necessarily dropping one goal in favor of the other, it's being explicit about the tradeoff up front, so your team knows which one takes priority when they genuinely conflict on a specific chart, rather than each person making that call differently and inconsistently throughout the year.

Set a review cadence, not just an end-of-year check

A goal set in January and revisited in December isn't really a goal, it's a hope. Build in a specific monthly or quarterly checkpoint where you actually look at the data again and ask whether the target is being met, and if not, why. This is also where a real drift, the kind that builds slowly and quietly, gets caught early instead of showing up as a surprise at year end.

Connect goals to what your team can actually influence

A reimbursement goal tied entirely to payer policy changes outside your control isn't a useful goal, since your team has no lever to pull to affect it. Goals built around documentation completeness, coding specificity, and functional scoring accuracy are ones your team can directly influence through their own daily work, which makes them both more motivating and more achievable.

Want help setting realistic targets based on your own numbers

We'd like to walk through your current accuracy and case mix data with you and help build specific, achievable goals for the year ahead.