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Member Insight: CDI’s skeleton in the closet

by Steven L. Griffin, DNP, RN, CCM, CCDS

CDI has a skeleton in the closet; an elephant in the room that we try to keep under our hat, off the record, on the sly, behind closed doors. Lean in closely, and I’ll reveal our seemingly shameful secret: CDI impacts reimbursement! Only 65% of respondents to a recent ACDIS CDI Leadership Council survey indicated that monitoring “financial query impact” was important.

Yet, this result starkly conflicts with a 2016 survey by Black Book Market Research where 87% percent of hospital chief financial officers (CFO) cited case-mix index (CMI) improvement as the largest motivator for CDI adoption. Black Book further reported that nearly 90% of hospitals with 150 or more beds gained at least $1.5 million in revenue after implementing a CDI program.

How do we reconcile these opposing views? When did CDI’s return on investment (ROI) fall out of vogue? Do CFOs suddenly lose interest in CDI’s financial contribution after programs are implemented? Doubtful. Without an ROI, what’s the basis for the annual budgeting of current programs? Or the cost-benefit justification for future expansion? Or the measure of accountability?

 

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