Developing the Next Generation of CDI Professionals

I recently attended an industry conference. I must say it was one of the best conferences I’ve attended in a long time. There was great content that gave me a new perspective, but what really motivated me was interacting with other attendees. I’m not sure if it is due to budgeting restrictions or the availability of virtual conferences, but attendance does not seem to be rebounding in our post-COVID world. 

It is a shame because with so many coding and clinical documentation integrity (CDI) professionals working remotely, we have less opportunities to collaborate and learn from each other. This is particularly important for those who are new to the profession or those who may not have many resources.  

I am self-taught when it comes to CDI. More specifically, I was never trained by a consulting firm. I started my revenue cycle career working for Human Military as a clinical trainer, which required me to learn all aspects of the revenue cycle from authorization through risk management. I bring this up because I tease that my “superpower” is my ability to understand and develop practices related to healthcare regulations and reimbursement mechanisms. I try to evolve as methodologies change.

I am one of those people who likes reading regulations.  When I started in CDI, I had limited resources.  The only way I could guarantee attending an industry conference was to be selected as a presenter. One of my very first CDI related presentations was for the American Health Information Management Association (AHIMA) on how to be your own CDI consultant because I figured there were others who also had to figure it out on their own. Attending the conference this year helped me remember that I need to balance discussing CDI innovations with the basics.

We are at a tipping point in this industry where our icons are retiring so we need to develop and support up and coming talent.  

Did you know if 2023 there were 191,500 medical records job openings? Coders are included in this Bureau of Labor Statistics finding. Employment opportunities are expected to grow nine percent from 2023 to 2033, “must faster than the average for all occupations.” This translates to about 15,000 openings on average for each year through 2033.

Many of the openings are due to the need to replace workers who exit the workforce. More specifically to professional coders, an article from Find-A-Code reports the American Medical Association (AMA) estimates the current professional medical coder shortage is around 30 percent.

Yet, while I was networking, I learned about this incredible program that is being implemented by the University of California Davis  to help neurodiverse individuals become professional coders. They are hoping to expand this program to other locations in California. This is such an innovative approach; I had to mention it because maybe other states or hospitals can follow suit.

CDI professionals may have a nursing background. The Bureau of Labor Statistics expect the need for nurses to grow by six percent with about 194,500 openings per year through 2033, which is also influenced by an aging workforce nearing retirement. This finding may be low if you consider the 2024 National Nursing Workforce Survey that found “40% of RNs report they plan to retire or leave nursing within the next 5 years.” Although CDI is not an option in this survey, a little less than one-third of surveyed nurses (32%) report not providing direct patient care, which likely represents those who work as CDI professionals.

As a CDI professional with a nursing background, I must admit that, in general, I did not find nursing to be a career with nurturing colleagues when I worked at the bedside. However, that completely changed when I attended my first industry conference for CDI professionals. There was such a buzz and desire to collaborate.

CDI is a profession where you get rewarded with more problems to solve as hospital leadership realize the value you bring to the table. This is why we keep innovating and expanding our reach into other areas of the clinical revenue cycle like quality, denials, and utilization review.

What makes CDI professionals successful is their critical thinking skills and that “can do” attitude. But it takes years to develop in this field because there are always unique situations as we navigate between coding guidance that allows a degree of subjectivity and complicated clinical scenarios that are increasingly being defined by payers, which is why collaboration is so important.

CDI professionals can contribute in so many ways. Many larger health systems and hospitals can create dedicated positions for quality, mortality, second level review, denials, education, etc., but many CDI departments are being asked to do more and more with limited resources and often must figure out how to incorporate these new requirements into their current workflows.

If you are feeling frustrated and burned out, no wonder. You are likely performing the work of more than one FTE due to the staffing shortages depending on where you work. CDI departments are likely to feel more pressure to demonstrate financial returns as hospitals continue to struggle to reclaim higher operating margins that existed pre-COVID.

We may not be at the bedside as CDI professionals but the work we do matters. The clinical revenue cycle keeps the hospital doors open.

Moreover, it is great to know that those who rose through the ranks of coding or CDI are reaching executive levels at hospitals. This is very important to our profession as these leaders understand the unique challenges of what we do and that our value extends beyond what can be measures with Case Mix Index (CMI) and CC/MCC capture. 

Hang in there and let’s work together to keep our profession growing. What I find most rewarding is mentoring so I hope every one of our readers can find an opportunity to share their knowledge or seek mentorship. There is no such thing as a dumb question. Most of the time, I learn something with every question asked of me.  And remember, most CDI professionals like a good mystery so collaborate and get other’s opinions.