The CDI Leadership Exchange is proudly sponsored by:
The Ballantyne™, a Luxury Collection Hotel, first opened its doors in 2001—quickly becoming a symbol of luxury and hospitality in the region. Located in the heart of Charlotte’s prestigious Ballantyne neighborhood, the property offers an opulent retreat for families and for business and leisure travelers alike. As a renowned AAA Four-Diamond destination, The Ballantyne combines Southern charm with undeniable elegance, providing an unforgettable experience for every guest who passes through its doors.
The Association of Clinical Documentation Integrity Specialists (ACDIS) is the nation’s only association dedicated to the CDI profession. ACDIS’ mission is to serve as the premier healthcare community for clinical documentation specialists. Since its inception in 2007, ACDIS has grown to nearly 7,000 members nationwide. ACDIS members enjoy the benefits of a membership journal, access to their peers in a CDI forum, helpful forms and tools, a CDI job board, and much more—including quarterly membership calls and the biweekly ACDIS Podcast. They also receive discounts to the association’s Boot Camp offerings and its national conference. ACDIS provides guidance and advocacy on behalf of its members and the CDI profession through its staff leadership, elected advisory board, local chapter leadership, and other boards and committees.
HEALTH & SAFETY: HCPro LLC places the highest priority on the safety of our guests. To safeguard all those in attendance at our events, we ask that you stay home if you are feeling unwell. If at any time you need support, please feel free to contact our event staff.
By accepting the invitation to the CDI Leadership Exchange, you agree that ACDIS will provide you information about the program or content for which you registered. ACDIS may also share information about other ACDIS conferences, products, and services, as well as messages from our strategic partners about their products and services. In addition, for events, programs, or content presented in collaboration with certain strategic partners, ACDIS will share registrant contact information with the applicable strategic partner. Information you provide will be processed in accordance with the ACDIS Privacy Notice. You may opt out at any time by contacting the ACDIS staff who invited you to participate in the Exchange.
WELCOME
Welcome to the ACDIS CDI Leadership Exchange!
At ACDIS, we know the role of a CDI leader is challenging and ever-changing with the needs of their department and their organization. Today’s CDI leaders are constantly assessing competing priorities and demands on their limited time. They are balancing staff needs with key performance indicator (KPI) metrics, involvement with denials management, potential areas for expansion and innovation, opportunities to deepen reviews to make a bigger impact for their organization, and more. All of these responsibilities and demands can leave a leader feeling overwhelmed, isolated in their role, and even burned out.
The Leadership Exchange helps give leaders the tools they need to advance their program, chart their own leadership journey, and lead their staff members effectively. Plus, it connects them with other leaders experiencing similar challenges—an invaluable resource. Our goal over the next two days is to share ideas between great leaders and give you an enjoyable opportunity to recharge.
A very special thank you to our sponsors, Iodine Software, SmarterDX, Solventum, formerly 3M Health Care, and Tendo, whose financial support makes our Exchange possible. We believe you will find this time to be a valuable exchange of ideas with the companies that deliver essential tools and intelligence for the industry as well as an opportunity to learn from your peers.
We are looking forward to hearing your thoughts and insight as part of the event discussions, but we also hope you are able to participate in the extracurricular events and enjoy your stay at The Ballantyne.
The ACDIS Team
PROGRAM AGENDA
SUNDAY, OCTOBER 20, 2024
6:00–8:00 p.m. – Carolina Ballroom
MONDAY, OCTOBER 21, 2024
7:30–8:00 a.m. – Fairway B
8:00–8:15 a.m. – Fairway B
8:30–10:00 a.m. Round A Sessions
Sponsor Session: Solventum, formerly 3M Health Care – Azalea
6:45–8:30 p.m. CDI Leadership and Physician Advisor Reception and Dinner – Carolina Ballroom
8:30 p.m. Adjourn
DISCUSSION GUIDE #1
KPIs, Analytics, and Managing Expectations
Session Moderator:
Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS, CDI Education Director for ACDIS and HCPro
Synopsis
When the CDI field began, professionals reviewed paper charts and sent paper queries, largely to capture CCs and MCCs for reimbursement purposes. Over the years, however, the role of the CDI department has expanded to denials management, outpatient settings, quality measure capture, and so much more. CDI programs have shifted focus and taken on innovative efforts, and leaders need to adjust their expectations for staff performance accordingly. Monitoring all the metrics, analyzing the data in a meaningful way, and managing staff and leadership time and performance could easily become a CDI leader’s full-time role.
During this session, participants will discuss how they determine which metrics to monitor, show impact for their program as it expands and grows, balance the time required for analyzing data against their other priorities, and manage expectations for their staff and department’s impact.
Key questions to consider during this session:
• As your CDI program matures, how do you decide what to track and trend? How long do you gather this data before presenting it to organizational leadership to prove success?
• How do you present nonfinancial KPIs to your organizational leadership and explain the value of these impacts? How do you present situations when CDI’s intervention might have resulted in a lower reimbursement (e.g., clinical validation efforts that remove an invalid diagnosis)?
• What systems or solutions do you use for tracking KPI data (e.g., a software solution versus a manual spreadsheet)? Do you use these same systems to export reports and present data to stakeholders?
• We often hear there’s a difference between “process” and “outcome” metrics. How do you differentiate between these types of metrics, and which are CDI staff held accountable to?
• If your metrics aren’t where you want them to be, how do you communicate this to leadership and staff? What steps do you take when a metric is showing a concerning trend?
• Does your team use a data analyst, or do you handle all the data analysis yourself as a leader? If you have an analyst, how did you justify that position from a budget perspective? And if you don’t have an analyst, how do you manage the time constraints of analysis with your other responsibilities?
• Because CDI is often seen as a “cure-all” for organizational woes, leaders may be tasked with improving outcomes that CDI has limited control over. How do you communicate realistic expectations to organizational leadership when taking on new responsibilities? How do you decide what’s within CDI’s scope and what’s not?
• If you have a departmental mission statement, how do you align your KPIs to that mission and ensure they support it as the program expands?
DISCUSSION GUIDE #2
Hiring, Retaining, and Auditing Staff
Session Moderator:
Linnea Archibald, Associate Editorial Director, Publications and Membership, for ACDIS
Synopsis
According to the most recent ACDIS CDI Salary Survey, more than 40% of CDI programs are planning to hire in the next year. Finding the right person to fill an open CDI position and then spending the time and resources to get them up to speed—especially if they don’t have prior CDI experience—can be a costly investment. CDI leaders, therefore, must develop ways to retain their staff long-term after training and monitor their performance to fill any educational gaps as they mature. While hiring, retention, and auditing occur at different points in the employee life cycle, if you will, a robust employee engagement program has sound strategies for all three.
During this session, participants will discuss how they attract top talent for their program, hire the right people, retain their staff over time to avoid being caught in the cycle of high overturn rates, and ensure their staff is operating at their highest capabilities.
Key questions to consider during this session:
• How do you determine staffing needs for your program (i.e., number of beds, discharges, patient populations reviewed, etc.)? When it is time to hire new staff or backfill a position, what do you look for in a strong candidate?
• What does your interview process entail? Do you test the candidate’s CDI competencies or rely on their resume and interview answers? Are there multiple rounds of interviews for the final candidates?
• After you hire a staff member, what does their orientation look like? Is orientation led by a CDI educator or another staff member? How does a staff member “graduate” from orientation (e.g., length of time versus demonstration of competency)?
• Once a staff member exits the orientation phase of their employment, how do you ensure their education continues throughout their tenure with the department? What opportunities for professional development do you offer staff members as they mature?
• Does your program have a career ladder for CDI staff members? If so, what are the rungs on the ladder, and do they correlate with pay increases? How does this structure impact staff retention?
• If a staff member shows signs of discontent and may leave the department/organization, what steps do you take to improve their engagement with the program and their role? How do you know when it may be better to let someone leave and backfill their position versus trying to keep them?
• Do you have a staff auditing or competency monitoring process in place to monitor performance? If so, what does that process entail (i.e., scope, staff involved, frequency, etc.)? How do you follow up on a staff member’s audit findings should you need to address a potential issue?
• How have staff members responded to your auditing or competency monitoring process? Do you feel it’s been a largely positive experience, or have you had to overcome some negative associations with being “tested”?
DISCUSSION GUIDE #3
Navigating Denials Management and Appeals
Session Moderator:
Rebecca Hendren, ACDIS Director
Synopsis
Denial volumes for most organizations have been steadily increasing over the years. As a result, CDI leaders are often tasked with developing solutions to stem the rising tide—yet this is easier said than done. Leaders must determine who needs to be involved in prevention and appeal activities, who will own these activities ultimately, and what responsibility each department and individual holds. Then, once processes are in place, leaders must constantly evaluate how their efforts are paying off and make adjustments in real time to continue to meet denial demands.
During this session, participants will discuss who is involved with the various components of prevention and appeals, how they monitor the success of their denials management efforts, and how they protect the department against scope creep while balancing demands.
Key questions to consider during this session:
• In what capacity is your CDI department involved with the denials management or appeals process? Why and how did you decide on that method? What other departments or groups within your organization did you have to work with?
• Who on your team is involved with denials management? Do you have a specific person (or group) that always handles denials management, or is it spread throughout the department in some way? Do you involve physician advisors as well?
• Have you been allowed to increase your staffing to deal with the additional work of denials management? If so, how did you make the case to hire more staff? When bringing on new staff members (or using existing staff) for this work, what education was necessary?
• Most organizations report the same top denied diagnoses: sepsis, respiratory failure, and malnutrition. Do these diagnoses reflect your experience? How have you worked to protect these vulnerable diagnoses from further denials? Do you have a clinical validation process, organizationwide clinical criteria, or appeal templates?
• Do you leverage your technology for denials management and appeals efforts? Are you using solutions geared toward this work, or one solution for all CDI efforts? If you don’t have technology to aid this process, how do you identify potential denial targets during CDI review?
• How do you track your impact on denials management and appeal efforts? Do you track manually or use technology for the CDI department specifically, or do you share data with another department, such as denials management or revenue cycle?
• Have you taken any steps to amend contracts with payers based on the trends found in your denials data? What did that process entail? What departments were involved?
• Have you taken any action regarding provider education related to denial trends? If so, how have you shared that information with providers (e.g., group versus individual setting, formal versus informal presentation)?
LIGHTNING ROUND
Chart Impact Rate: From Traditional Metrics to Measuring True Impact
Presented by: Elisa Sninchak, MBA, M.Ed, BSN, RN, CCDS, CDIP, CCS, director of clinical documentation excellence at Novant Health in Charlotte, North Carolina
During this session, attendees will learn how designing a chart impact rate provides meaningful feedback for the team and identifies areas of needed improvement, including education, coverage shifts, and increased professional accountability. The chart impact rate data reflects CDI value and impact in a clear and measurable way for leaders and stakeholders, instead of telling only portions of the story through traditional metrics.
Navigating the Physician Advisor Career Ladder
Presented by: John Pettine, MD, FACP, CPHQ, CCDS, vice president and chief medical officer, revenue operations at Lehigh Valley Health Network in Allentown, Pennsylvania
This presentation outlines the physician advisor career ladder for leadership roles in CDI, utilization management, and tangential areas. It covers the progression from entry-level physician advisor to senior and executive leadership roles, highlighting key competencies and responsibilities at each stage. Attendees will gain insights into essential skills, educational requirements, and practical strategies for advancement. The chief objective is to equip attendees with the knowledge to navigate and excel in leadership positions within these critical healthcare functions.
Identifying and Mitigating Burnout in CDI
Presented by: Traci Lindner, RN, CCDS, CDI manager at Marshfield Clinic Health System in Marshfield, Wisconsin
Like many professions, stress and burnout occur when working in CDI and can affect both leaders and staff alike. During this session, attendees will first learn how to identify why and when burnout is happening. Then, leaders will learn takeaway ideas to understand what CDI leaders can do to mitigate stress and burnout for themselves and for their team members.
The Intersection of Clinical Documentation and Quality
Presented by: Carolyn Bauer, MD, medical director for clinical documentation at Montefiore Medical Center in New York, New York
Many quality programs such as Medicare star ratings, Leapfrog, and U.S. News and World Report use ICD10 codes as the basis for their quality scoring. We developed a multimodal approach to ensure accurate capture of both our complications and our risk adjustments. Learn how our hospital uses technology, institutional clinical definitions, physician education, and a multidisciplinary prebill review of CMS mortality cohorts and Patient Safety Indicators to improve our monthly metrics.
PARTICIPATING LEADERS
LEAH AINSWORTH, BSHIIM, RHIT, CCS, CDIP, CCDS Director, Coding & CDI Springhill Medical Center/Mobile, AL leah.ainsworth@springhill.org
VICKI BROWN, RN, BSN, CCDS System Director of Clinical Documentation Integrity Baptist Memorial Health Care Corporation/Memphis, TN vicki.brown@bmhcc.org
DAN BRAY, RN, CCDS, CDIP Corporate CDI Manager Cape Fear Valley Health System/Fayetteville, NC dbray@capefearvalley.com
ANGELICA CAGE, MBA, BSN, RN, CCDS, CCS, CDIP CDI Director Tufts Medicine Health System/Boston, MA angelica.cage@outlook.com
CHERYL CODNER, RN, MPH, CCDS Interim Director of CDI at BWH/BWF Brigham and Women’s/Brigham Faulker/Billerica, MA ccodner@bwh.harvard.edu
CLARK, BAN, RN, GERO-BC, CCDS Supervisor, CDI Sanford USD Medical Center/Sioux Falls, SD debra.clark@sanfordhealth.org
PATRICIA DASCH, RN, CCDS Director, Clinical Documentation Excellence, JHHS Shared Service Johns Hopkins Health System/Spring Grove, MD pdasch1@jhmi.edu
DEB
PARTICIPATING LEADERS
MARY ALICE DEWEES, BSN, RN, CCDS, CRC System Director of CDI Hartford HealthCare/Farmington, CT maryalice.dewees@hhchealth.org
DENICE SHELTON, BSN, RN, CCDS, CRCR Director Clinical Documentation Improvement UVA Health System/Charlottesville, VA dvl4m@uvahealth.org
MELODY TYISKA, RHIA, CCS, CPC, CPMA, CHA, OHCC, CCP-P Director HIM/CDI St. John Episcopal Hospital/Far Rockaway, NY mtyiska@ehs.org
LENA WILSON, MHI, RHIA, CCS, CCDS CDI Manager Indiana University Health/Indianapolis, IN lwilson9@iuhealth.org
ACDIS INTRODUCTIONS
Rebecca Hendren is the director of CDI and revenue integrity for ACDIS and NAHRI, and in this role serves as the director of ACDIS. She is responsible for managing ACDIS and NAHRI’s strategic directions, including evolving the organizations, overseeing educational products and services, reviewing member benefits, and ensuring both associations provide thought leadership and authoritative voices in the industry. She is a member of the NAHRI Advisory Board and the ACDIS Advisory Board, and currently hosts the “Talking CDI” series on the ACDIS Podcast.
Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS, is the CDI education director for ACDIS/HCPro. In her current role, Wilk promotes educational initiatives within the realm of CDI. She develops comprehensive education materials, conducts live and virtual sessions, and contributes articles and educational content for publication. With a solid foundation in academia, she is actively involved in curriculum development and utilizes various teaching methodologies to enhance student learning. Previously, she held key leadership positions across multiple organizations. Most recently, she held a CDI director position, leading a multidisciplinary team across multiple hospital facilities. Her responsibilities encompassed staff education, process optimization, quality initiatives, and collaboration with various departments to achieve organizational goals. Additionally, Wilk established the Central Pennsylvania ACDIS local chapter, served on the ACDIS Advisory Board from 2017 to 2020, and is currently serving on the ACDIS CDI Regulatory Committee and the Advisory Board again.
Linnea Archibald is the associate editorial director, publications and membership, for ACDIS. She oversees the management and strategic development of the ACDIS Leadership Council and associated Mastermind groups, including membership recruitment and engagement, and day-to-day offerings. Archibald is responsible for the strategic planning of ACDIS’ publications, including the CDI Journal and CDI Strategies, works closely with ACDIS’ Diversity and Inclusion Committee and Chapter Advisory Committee, and is responsible for the oversight of ACDIS’ local chapters and networking groups. She hosts the “Leadership With Linnea” series on the ACDIS Podcast and is responsible for planning and producing the show. Additionally, she handles the strategic oversight of ACDIS’ social media presence.
ABOUT OUR SPONSORS
Iodine Software builds transformative technologies that make healthcare work. Our proprietary AI engine, CognitiveML, automates clinical and administrative revenue cycle work, thereby improving reimbursement and enabling clinicians to focus on the delivery of high quality, patient-centric care.
SmarterDx builds clinical AI that empowers hospitals to achieve 100% chart accuracy for revenue integrity. Our solution helps hospitals tell the most accurate and complete story of the patient and the care that was delivered, which helps them recover millions in earned revenue and improve quality of care scores.
At Solventum, formerly 3M Health Care, we create breakthrough solutions for our customers’ toughest challenges by pioneering game-changing innovations at the intersection of health, material, and data science to change patients’ lives for the better—while enabling healthcare professionals to perform at their best.
Tendo’s QDI application delivers actionable recommendations to improve the accuracy and completeness of documentation for risk adjustment conditions that impact Quality rankings and ratings, value-based care programs, and revenue enhancement. Our Tendo Insights dashboards offer real-time analytics and reporting that empower decision-making, identify documentation trends, and support provider education. Outcomes include elevated U.S. News & World Report rankings and improved CMS Stars ratings at both the organizational and service line levels. Looking ahead, Tendo’s 2025 new features will include NLP to identify CC/MCC opportunities, encoder functionality within the QDI application, and a new Ambulatory CDI product.
It’s time to receive credit for your outstanding clinical quality. www.tendo.com/healthcare-analytics
