The ICD-10 implementation delay has resulted in many providers either slowing down or suspending their efforts to prepare for the transition, a recent survey from the Workgroup for Electronic Data Interchange found.
Only half of the providers surveyed in August had completed an ICD-10 impact assessment, and only one-third had begun ICD-10 testing. WEDI Chair Jim Daley has warned that the stalled implementation efforts could lead to "significant disruption" when the transition to the new coding system takes place on Oct. 1, 2015.
Aside from avoiding chaos on the day of the transition, hospitals and health systems can gain a competitive advantage and see immediate performance improvement if they continue to move forward with their ICD-10 preparation efforts, according to Craig Greenberg, national practice director, strategic advisory services at healthcare management consulting firm Beacon Partners. "It really touches virtually everywhere throughout the enterprise," he says of ICD-10. "Identifying gaps and deficiencies today and taking steps to correct them certainly will help improve their performance now."
By taking the following four actions, hospital and health system leaders can strengthen their organizations and reap the benefits of performance improvement now, in addition to readying themselves for the switch to ICD-10 next year, according to Mr. Greenberg.
1. Optimize the revenue cycle. Streamlining the revenue cycle will help providers prepare for ICD-10 in addition to benefiting them in the short-term through more efficient and accurate performance. Mr. Greenberg recommends that they start by looking at key indicators such as denial rates, collection percentages and days in accounts receivable to identify opportunities for improvement.
Although it's critical for providers to do this in anticipation of a projected 30to 40 percent dip in revenue after the switch to ICD-10 as everyone in the healthcare industry adjusts, hospitals and health systems should work on improving revenue cycle management regardless, Mr. Greenberg says: "One way to look at this...is these are really not things that should be emphasized solely because of ICD-10. These are just best practices to streamline the revenue cycle."
2. Develop a clinical documentation improvement program. Most healthcare organizations recognize the value of strong documentation. Before the transition date was pushed back, hospitals and health systems might not have had time to adequately address CDI. The delay presents an opportunity to thoroughly address clinical documentation. "Unexpectedly, organizations were given more time, so let's look at project plans…and stretch them out a little bit to where we can focus a little bit deeper," Mr. Greenberg says. "Organizations can look deeper at certain functional areas and how to improve them."
Better documentation will also benefit hospitals and health systems in ways beyond preparing them for the transition to the new coding system. For instance, providers should be documenting quality outcomes, a step that's necessary to attest to meaningful use, according to Mr. Greenberg.
3. Ensure integration with physicians. Hospitals and health systems are increasingly acquiring and taking on the management of physician practices. However, after the transactions, the physicians and the health systems often continue to operate using disparate systems, according to Mr. Greenberg. Finding a way to centralize functions such as billing and access to clinical records (EHRs) can improve performance and workflow— in addition to preparing the providers for ICD-10.
"Where they could be aided by technology is looking at and undergoing a project to identify a system that's seamless, a single system across their enterprise," he says. "It improves their performance, it improves efficiency and it definitely improves the patient experience."
4. Look at the transition overall as more than an IT project. One mistake many organizations have made is looking at the switch to ICD-10 as merely an IT undertaking. "In other words, we have to fix our systems, we get them upgraded, format them to take on the new code set," Mr. Greenberg says. "Once we do that we can hit the ground running. That's certainly a big part of preparation, but it is by no means the only part."
Coding affects all aspects of operations at the hospital or health system (from billing to documentation, reporting, and beyond), and it's important for healthcare leaders to remember that when laying out a plan of action for the switch. "Codes reside everywhere throughout a healthcare organization, and organizations don't always recognize that in terms of getting ready," he says. "A really focused, comprehensive project plan is necessary that addresses every area."