When Was the Last Time You Pressure-Tested Your HIM Program? 

The first quarter gives you time to “reset” and brings a new start and new perspective. Things feel under control – stable and achievable. Volumes are predictable, workflows are familiar, and performance metrics look consistent with expectations. For many HIM and compliance leaders, that stability is a sign the program is doing what it’s supposed to do. The challenge is that stability doesn’t always mean optimal performance. In fact, it often means “status quo”. 

Strong Programs Drift—Even When Teams Are Doing the Right Things 

Most HIM programs evolve continuously. Documentation habits shift, coding guidance changes, workforce changes are constantly happening in the revenue cycle and the clinical staff, payer behavior adapts, and automation alters how work gets done. These changes rarely feel disruptive in the moment. Teams adjust, workarounds are created and root causes of issues often go unnoticed. 

Over time, though, those small shifts can pull a program away from how it was originally designed to operate. Not because anyone did something wrong—but because the work moved faster than the governance around it. Feel familiar? Many HIM Directors say “that sounds like my life.” This kind of drift is common. It’s also difficult to see from inside the program when dealing with the day-to-day. 

Why Dashboards Don’t Always Answer the Right Questions 

Operational reports and dashboards are essential, but they tend to answer narrow questions: 

Are we meeting productivity targets? 

Are quality scores within range? 

Are denial rates stable? 

What they don’t tell you is the whole story. In addition, they don’t consistently show is why performance looks the way it does—or how much manual effort, workaround, or risk is sitting beneath the surface to keep those metrics green. 

Because reporting is often siloed by function, a holistic picture is difficult to see. Reporting often doesn’t show early signals of misalignment across documentation, CDI, coding, and denials which can remain invisible until something changes downstream. 

Q1 Is the Easiest Time to Take an Objective Look 

Later in the year, reviews are often triggered by a problem: a denial trend, an audit, a quality score shift, or regulatory scrutiny. By then, the conversation is about fixing, defending, or explaining. 

Q1 offers a different opportunity. 

Early in the year, HIM and compliance leaders can step back and ask a simpler question: 

Does the way our program is operating today still match how we believe it’s operating and how we want it to operate? 

A focused review isn’t about finding fault or identifying who is doing a bad job. It’s about establishing a clear baseline—what’s working as intended, where workflows have drifted, and where small adjustments now can prevent larger issues later. 

Why This Matters for HIM and Compliance Leaders 

When questions arise later in the year, they’re rarely framed around effort. They’re framed around outcomes. Leaders who have already evaluated their programs can speak confidently to what they know, what they’ve validated, and what they’ve proactively addressed. Those who haven’t stepped back to do an objective evaluation are often forced to rely on assumptions and high-level metrics that don’t tell the full story. 

Taking time early in the year to independently evaluate program health isn’t a sign that something is wrong. It’s a sign of professional stewardship—one that protects revenue, teams, supports credibility, and reduces the likelihood of surprises when visibility increases later in the year.