AHIMA: Revenue, readiness remain among top ICD-10 concerns

By Jennifer Bresnick for ehrintelligence.com

Despite the extra year of prep time granted by the ICD-10 delay, a significant number of providers remain worried about how they will meet the demands of the transition to the new code set, now slated for October 1, 2015, and how ICD-10 will impact their practices in the aftermath. In a survey conducted by AHIMA and the eHealth Initiative throughout May and June, 38% of providers predicted that their revenue will decrease in the first year after ICD-10, while 26% of organizations have not even conducted a revenue impact assessment. Widespread concerns over documentation and productivity remain, but providers also appeared eager to begin testing and tackle the hurdles laid out before them.

The 349 respondents, representing a variety of providers, hospitals, and other stakeholders, anticipate some serious short-term problems during the months following the transition. Sixty-one percent said that coding patient encounters would get harder, while 44% are concerned about difficulties in documenting patient encounters and 41% believe that adjudication of reimbursement claims, including historical analysis of ICD-9 codes, will also pose a problem. Other barriers to success include interruptions in clinical workflow, productivity, and claims processing, cited by 57% of providers, a lack of adequate staff, change management issues, and the readiness of vendors and partners.

But the respondents were quick to note that these immediate concerns would dissipate as the long-term benefits of ICD-10 became clear. Four in ten providers think the accuracy of claims will eventually increase, while a quarter think the new codes will have a positive impact on the quality of care and patient safety. Reimbursement will likely get even more efficient, said 20% of respondents, and a similar number have hope that ICD-10 will foster better payer-provider collaboration.

A majority of providers plan to use the increased specificity of ICD-10 data to help with quality improvement and performance measurement, while 39% anticipate boosting their outcomes measurement and 25% will scrutinize their resource allocation.

While it may be good news for ICD-10 advocates that providers are starting to recognize that the more detailed code set might being improvements to the healthcare system, the path towards those positive outcomes remains rocky and uncertain. Testing is the big obstacle on everyone’s minds, and they are planning to attack it soon. Twenty-seven percent of respondents believe they will be ready for testing by the third quarter of 2014, while 14% will be ready by the end of the year. Only 2.5% will put it off until the end of 2015, but 10% currently have no plans for testing at all.

Of the organizations who don’t have scheduled testing dates, a whopping 41% say it’s because they don’t know what to do. Others think it will cost too much, and 14% even believe that testing is unnecessary. The majority of these organizations are physician practices.

For those who are not letting the extra year get them down, despite many anticipating that the costs of the extension might double their expenditures, extra training and practice for coders is first on the list of readiness priorities. Sixty-eight percent will bulk up their education, while 31% will hire more coders and 29% will invest in computer assisted coding (CAC) technology or other health IT tools to help their staff along as the added time starts to tick away again.