Journal excerpt: Tracking difficulties with financial ROI

At first blush, tracking financial return on investment (ROI) for CDI efforts may seem straightforward, but that’s not always the case, says Tamara Hicks, BSN, MHA, RN, CCS, CCDS, ACM-RN, CCDS-O, director of clinical documentation excellence at Wake Forest Baptist Health in Winston-Salem, North Carolina. In order to prove a positive ROI, you must first extrapolate what the reimbursement would have been without CDI intervention.

“We calculate the financial ROI based on queries and responses to queries,” she says. “We also look at the change in DRG that a diagnosis would have gone to and the DRG that it ended up going to after any query or intervention by CDI.”

To calculate this financial impact, Hicks looks at how much revenue the department brings in each month and subtracts the cost to run the CDI department, which gives her the net ROI amount each month. This information is presented in a monthly dashboard and goes out to the organizational leadership team. Before being imported into the dashboard, the financial ROI information is pulled into a spreadsheet workbook with combined information for the overall health system, as well as broken out into separate spreadsheets for each of Wake Forest’s five facilities.

“When we first started tracking this financial ROI information, we had a consulting group come in that helped us decide what to track and what not to and were advised on some tools that would help us with this,” Hicks says. “CDI staff manually put in the information, so still to this day we go back and spot check from time to time to make sure everything was entered correctly.”

Editor’s note: This article is an excerpt from the March/April 2021 edition of the CDI Journal.