Health Information Management

HIM directors’ salaries on the rise, but profession isn’t exempt from poor economy

JustCoding News: Inpatient, November 11, 2009

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Editor’s note: Data in this article represent the responses of 349 HIM directors from hospitals in the following bed-size categories:

  • Fewer than 150 beds (51%)
  • 151–300 beds (26%)
  • More than 300 beds (23%)

The good news
HIM director salaries are on the rise, according to HCPro’s Medical Records Briefing salary survey, results of which were published in the October and November issues of the newsletter.

Half of the 349 respondents said they earn more than $80,000 annually, up from 45% in 2008. Thirty-six percent make more than $90,000 annually. “I think the pay in our field is really beginning to commensurate with the wide range of knowledge HIM professionals are expected to have,” says Kelly Ward, RHIA, director of management and operations services at Healthport in Nixa, MO.

As HIM directors continue to expand their knowledge of informatics, finance, hospital organization, pharmacy, and policy, the numbers will continue to rise, says Patt Peterson, MA, RHIA, director of education at the American Health Information Management Association in Chicago.

HIM stimulus funds are also likely to put the profession in the spotlight. “Health information technology [HIT] is a prominent aspect of the ARRA [American Recovery and Reinvestment Act] legislation with $220 million set aside for HIT education to prepare workers for careers in HIT and related areas,” says Peterson.

The survey revealed that 33% of respondents are members of a work group or committee that oversees the meaningful use prerequisite for electronic health record (EHR) incentive funds required by ARRA.

“I’m glad that our professionals are being sought because this means that we’re being looked at for the data collection requirements that are going to be involved in meaningful use and setting up the appropriate field settings,” says Rose T. Dunn, RHIA, CPA, FACHE, FHFMA, chief operating officer of First Class Solutions, Inc., in St. Louis.

Higher salaries also are indicative of the changing competencies that healthcare organizations require, says Dunn. Employers seek credentialed individuals with significant technical expertise and the ability to oversee EHR implementation, she says.

Baby boomer turnover has greatly contributed to higher salaries overall, says Dunn. “We’re in that period where baby boomers are retiring. Talented individuals coming in [to the profession] are commanding a higher rate of pay,” she says.

The bad news
Despite this growth, the weak economy has taken its toll on the profession. HIM directors are not exempt from increased demands as hospitals streamline processes and implement cost-cutting measures.

“Due to the economy, some facilities are assigning additional responsibilities to the present director instead of hiring any new positions to help or replacing current existing positions,” Ward says.

The salary survey confirms this. Forty-five percent of respondents oversee HIM functions for multiple settings, up from 35% in 2008.

“I don’t think [this] says as much about the HIM profession as it does how healthcare systems are realigning their organizations,” says Dunn. “I think they’re breaking up the units into finer pieces so that the level of leadership required is lower. This costs less, and the overall direction is being done by fewer director-level individuals.”

Dunn says EHRs will continue to be the driving force behind the streamlining of director-level positions. As HIM becomes more virtual and hospitals merge into larger systems, some HIM director positions may be completely eliminated. This will require a single HIM director to oversee multiple settings, she says.

Directors increasingly oversee non-HIM functions. The survey revealed that 81% of respondents oversee hospital functions other than HIM, up from 66% in 2008.

These statistics are testimony to a down economy, says Ward, adding that “facilities are expecting everyone to wear more hats.”

Several respondents said they oversee case management at their facilities. Directors are becoming more involved with Recovery Audit Contractor initiatives because of HIM’s inherent connection with this function, says Dunn.

Added responsibilities should equal higher pay, says Dunn. “I think you should get paid more if you have a broader scope of responsibility. If you have HIM, case management, and [patient] access, you have three headaches rather than just one,” she says.

Professionals continue to seek recognition
Unfortunately, the HIM profession continues to be overlooked, says Peterson. “In terms of knowledge, capabilities, and planning, no other allied health professionals can compare,” she says. “The biggest hurdle to overcome is urging our members to raise awareness of the profession and of their own contributions to their organization.”

All HIM directors should have an “elevator speech”—a 60-second version of what they do and why HIM is important, says Peterson. A good speech would emphasize that healthcare administrators, clinicians, and HIT professionals need HIM directors’ skills to implement a national EHR solution.

Several respondents echoed Peterson’s sentiments regarding the fact that HIM is overlooked. “I believe that HIM directors and the department in general are misunderstood, and the scope of the skill sets involved are underappreciated,” wrote one respondent.

But the squeaky wheel gets the grease. Directors who feel underappreciated should use that to effect change and promote the profession within their organizations, Dunn says. “In some organizations, the HIM director is highly respected, pulled into many meetings, committees, and forums, and sought after for their opinion,” she says. “In other organizations, the HIM director does not step outside of their four walls, and they’re not seen or recognized.”

HIM directors should realize that their role has become increasingly more diverse and important, says Ward. “We work closely with IT departments in making important decisions about HIM systems and how they should work. We are more involved in revenue, chargemaster, and RAC preparedness meetings,” she explains.

Salaries—and spirits—looking up
Overall, respondents seem more pleased with salaries, according to the survey. When asked whether HIM directors receive fair compensation for the work they do, 54% said no. This is slightly less than the 58% who responded similarly in 2008.

This statistic surprised Ward. “I see some excellent salaries in the areas of revenue cycle management, clinical documentation, and system director positions,” she says. “There always seems to be a place for advancement in HIM to increase your salary.”

Despite the bleak economy, 71% of respondents said they received a raise in the past 12 months.

“This is actually surprising,” says Ward. “Many hospitals are cutting staff and having hiring freezes.”

Respondents who didn’t receive a raise may want to think twice about asking for one, says Dunn. “Administrators are going to be expecting their leaders to apply common sense and logic, and if layoff[s] … are occurring throughout the organization, that’s not the time for you to ask for a raise,” she says.

Conversely, if you don’t request a raise, you won’t receive one. “It never hurts to toot your own horn,” Ward says. Directors who plan to ask for a raise should note their accomplishments throughout the entire year, including goals set and met, she says.

Editor’s note: E-mail Ward at

 E-mail Peterson at

 E-mail Dunn at

 This story was originally published in the October issue of Medical Records Briefing.

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