HIM 660 Module 9 Final Project Example

Final Project: Faster, Fuller, Fairer. A Three-Year Strategic and Financial Plan for Health Information Management at Kanawha Ridge Health

[Student Name]

Southern New Hampshire University

HIM 660: HIM Strategic Planning and Financial Management

Final Project

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Final Project: Faster, Fuller, Fairer. A Three-Year Strategic and Financial Plan for Health Information Management at Kanawha Ridge Health

Executive Summary

Kanawha Ridge Health's health information department codes accurately but slowly, relies on expensive contract labor and has no program to improve documentation while patients are in the hospital. As a result, about $14.6 million sits in unbilled accounts on an average day, roughly one claim in eight is denied on first submission and denial write-offs reach $2.9 million a year. This plan asks the chief financial officer to fund three initiatives over three years: a phased clinical documentation improvement program, a coder workforce plan and two denial analysts working across HIM and the business office. Together they require about $2.3 million in spending over three years and are expected to return about $5.0 million, for a net present value of about $2.4 million at the system's 6% planning rate. The plan is built to be faster, fuller and fairer: faster coding, fuller documentation and fairer treatment of patients when the system's own processes fail.

Mission, Vision and Alignment

As a mission, the department commits to a full and faithful record of every patient's care at Kanawha Ridge, converted promptly and correctly into the coded information that pays the system, measures its quality and answers patients' requests. Looking to 2029, it aims to code each discharge in three days or less and each chart will show how sick the patient truly was. Both follow from the system's mission of high-quality care close to home and support two of the system plan's five goals, financial sustainability and success in value-based contracts. Kaissi and Begun (2008) found that hospitals whose plans had executive ownership and board involvement reported stronger finances, so this plan names the chief financial officer as its executive sponsor and will be reported to the board's finance committee twice a year.

Where the Department Stands

The strategic assessment measured ten indicators for fiscal 2026. Coding accuracy (95.8%) and release of information turnaround (3.1 days) meet their targets and are strengths to protect. The department misses its targets on days to final coding (6.8 against 4.0), first-pass denials (12.1% against under 8%), contract spending ($1.08 million against a $620,000 budget) and vacancies (five of 38 coding positions). It has no documentation review at all. Externally, a payer mix with about a quarter of discharges covered by Medicaid leaves little margin for delay, and federal payment policy keeps moving money into arrangements in which coded diagnoses set targets and shared savings (Burwell, 2015).

Goals

Five goals run to June 2028. The department will launch documentation review by January 2027 and reach 12 queries per 100 inpatient discharges with a 90% physician response rate by June 2027. It will cut the coding wait from 6.8 to 4.0 days, lowering average unbilled accounts toward $8.5 million. It will reduce contract coding to $300,000 a year with no more than two vacancies. It will lower first-pass denials to 9% and write-offs by a quarter. And it will hold accuracy no lower than 95% while keeping release of information within five days.

Initiatives and Financial Case

Table 1 summarizes the three initiatives and their financial results. The documentation program draws on evidence that documentation specialists can raise both revenue and physician engagement, including a surgical service where query responses rose from 17% to almost 95% (Castaldi & McNelis, 2019). Only the payment gained from fuller documentation is credited to that program; all reductions in denial write-offs are credited to the denial team so that no dollar is counted twice.

Table 1. Initiatives, Three-Year Costs and Returns

Note. Costs and benefits from Milestone Three. The documentation figures show the full-program case; the phased launch lowers first-year cost.

Why the Documentation Program Is Phased

Sensitivity testing showed that the documentation program's value depends on one assumption: a case mix gain of 0.02. Below a gain of about 0.011, the program costs more than it earns, and a one-year delay in reaching full effect turns its three-year net present value negative. The plan therefore starts with two specialists on the medicine and cardiology floors for two quarters, with a target gain of 0.01 in those services, before hiring the other two and the physician advisor. The phasing costs a few months of potential benefit but protects the system from funding a full program on an untested estimate.

Implementation Timeline

Table 2 shows the order of work. Hiring and denial edits come first because they pay back fastest and free the cash and staff time the documentation program needs.

Table 2. Implementation Timeline

Note. Quarters run from plan approval.

Measuring Progress

Progress will be tracked on an eleven-measure balanced scorecard that sets money beside physicians and patients, workflow and staff development, each line with an owner. Amer et al. (2022) found that balanced scorecards in health care organizations were associated with better patient satisfaction and financial performance, and the scorecard's main value here is that savings cannot hide problems in accuracy, physician engagement or staff retention. A steering group of the HIM director, revenue cycle director, physician advisor and a finance analyst reviews it monthly, and the plan is refreshed every quarter.

Fairness to Patients

Denials are not only a revenue problem. Lower-income patients and patients from historically disadvantaged groups bear the heaviest burden of claim denials and are least likely to see them corrected (Horný et al., 2025). Under this plan, a denial that traces to Kanawha Ridge's own mistake, whether an authorization nobody requested or a wrong code, stays off the patient's statement until someone reviews it, and the scorecard adds a measure of patient balances created by such errors and the time taken to reverse them. That measure costs little and keeps the plan honest about whom it serves.

Risks

The main risks are physician resistance to queries, coders hired remotely who leave for larger employers and denial causes that sit outside HIM's control. The plan answers them by presenting queries as clinical clarification with medical staff leaders involved, measuring retention rather than hiring alone and sharing the denial team with revenue cycle so that technical denials have an owner outside HIM.

Request and Conclusion

The department asks the chief financial officer to approve the workforce plan and the denial team now, to approve the documentation pilot with a decision on the full program after two quarters and to sponsor the plan before the board's finance committee. The plan asks for spending that returns more than twice its cost, protects the department's strengths and treats patients fairly when the system makes mistakes. It turns a department that waits on its backlog into one that plans where it is going.

References

Amer, F., Hammoud, S., Khatatbeh, H., Lohner, S., Boncz, I., & Endrei, D. (2022). The deployment of balanced scorecard in health care organizations: Is it beneficial? A systematic review. BMC Health Services Research, 22, Article 65. https://doi.org/10.1186/s12913-021-07452-7

Burwell, S. M. (2015). Setting value-based payment goals: HHS efforts to improve U.S. health care. New England Journal of Medicine, 372(10), 897-899. https://doi.org/10.1056/NEJMp1500445

Castaldi, M., & McNelis, J. (2019). Introducing a clinical documentation specialist to improve coding and collectability on a surgical service. Journal for Healthcare Quality, 41(3), e21-e29. https://doi.org/10.1097/JHQ.0000000000000146

Horný, M., Yu, O., & Hoagland, A. (2025). Claim denials: Low-income patients from disadvantaged racial and ethnic groups experienced the largest burdens. Health Affairs, 44(6), 707-715. https://doi.org/10.1377/hlthaff.2024.01277

Kaissi, A. A., & Begun, J. W. (2008). Strategic planning processes and hospital financial performance. Journal of Healthcare Management, 53(3), 197-208. https://doi.org/10.1097/00115514-200805000-00011