ACDIS celebrates CDI professionals annually with a full week of recognition for the profession through activities, education, and fun. This year’s CDI Week theme is CDI Success Stories: Writing your next chapter, aiming to encourage CDI professionals of any background to find personal success and write their own unique, prosperous future in the CDI industry.

Each year leading up to CDI Week, ACDIS releases a survey to gain insight into the state of the industry. This year’s survey included questions about provider engagement, outpatient CDI and risk adjustment, professional development and staffing, denial trends and CDI involvement, and workflow tools and technology. It marks the 13th annual CDI Week Industry Survey, continuing more than a decade of industry evaluation.

“The annual survey report provides a valuable overview of the current state of the industry as the CDI profession continues to expand, diversify, and evolve,” says Kelly Sutton, RN, BNS, MHL, CCDS, CCS, the CDI educator at Providence Health & Services in Oregon. “CDI professionals gain a better understanding of the successes and differences across other programs. The report also assists in the identification of opportunities within their own programs.”

This year, 781 respondents took part in the survey. Although this report will not discuss every survey question in detail, readers can examine all the responses in table format beginning on p. 12.

Survey respondents were first asked their title and role to understand the demographics and scope of positions within the field. CDI specialists made up the largest group, with 30.91% of respondents fitting into this role. This number continues a year-over-year decline, this time significantly from last year’s 43.32% of respondents. On the other hand, the number of respondents who are in leadership roles continues to increase, including CDI managers (21.29% versus 18.28% in 2022), supervisors (5.21% versus 3.66% in 2022), and directors (15.30% versus 12.66% in 2022). CDI educators also saw an increase from 3.09% in 2022 to 4.73% this year. The shift from respondents in CDI specialist roles to those in higher positions may demonstrate individuals growing within their careers, and a greater interest among CDI leadership in participating and collecting industry data. (See Figure 1.)

In comparison to the last two years, the percentage of respondents working in an acute care hospital (40.06%) continues to decrease (from 45.29% in 2022). Meanwhile, the percentage who work for a healthcare system with multiple sites rose from 26.44% in 2022 to 33.28% this year. (See Figure 2.)

Most respondents (56.30%) have been in their current role between zero and five years, back to normal from a spike in that category in 2022 (60.62%). An additional 19.24% have been in their role for six to eight years, and only 0.47% of respondents have been in their current role for more than 20 years. (See Figure 3.)

When respondents were asked how long they intend to stay in CDI, their answers were spread fairly widely across the board. Most respondents said they intend to stay for more than 20 years (18.77%), and 12.46% of respondents picked the middle road and answered nine to 10 years, while 16.72% answered that they are unsure. (See Figure 3.)

A smaller number of respondents (25.23%) indicated their facility has between 101 and 400 beds than in the previous year (30.66%), in congruence with the increase of those who reported more than 1,000 beds (from 12.94% to 18.30%). (See Figure 4.) As far as total number of beds in their health system, 29.18% of respondents reported 3,000 or more, steady with 2022 survey results. Those with more than 2,000 beds in their healthcare system increased (from 36.43% in 2022 to 40.85% in 2023), while those who answered they are not part of a healthcare system decreased slightly from 14.77% in 2022 to 13.41% in 2023. (See Figure 5.) 

Because of the great diversity in background of CDI professionals, it comes as no surprise that they hold an extensive assortment of credentials. Most respondents (74.13%) noted that they hold an RN credential, and 66.89% of respondents hold ACDIS’ Certified Clinical Documentation Specialist (CCDS) credential, an increase from 61.88% the previous year. All other credential options offered on the survey had lower response rates. For example, 18.30% of respondents noted holding the Certified Coding Specialist (CCS) credential, 13.09% hold the Certified Documentation Improvement Practitioner (CDIP) credential, and 7.10% hold a Registered Health Information Administrator (RHIA) credential. A general increase was seen across all these credentials, possibly because of the increase in respondents with leadership roles. (See Figure 6.)

When asked about CDI’s place on the org chart, 34.54% of respondents said their CDI department reports to revenue integrity/cycle, followed by 17.67% of respondents who report to HIM/coding. Quality came in third for the first time, reported to by 14.20% of respondents. Finance garnered 13.88% of responses, and 5.36% of respondents indicated they have a standalone CDI department. (See Figure 7.)