Preparations for ICD-10 Still Lagging

Findings from a new survey from AHIMA and the eHealth Initiative show that a significant number of providers are still missing some of the basic building blocks of a successful conversion to ICD-10, including financial impact assessments and plans for internal and external testing.  As the ICD-10 deadline of October 1, 2015 begins to loom, the industry faces a lack of education, understanding of the changes, and firm plans that puts some organizations at risk for potentially devastating reimbursement disruption. And there is a growing gap between well-prepared organizations and those with preparations yet underway.  Familiar challenges such as clinical documentation improvement, coder productivity, and the scope of financial investment still top the list of worries as the industry moves closer to the deadline.

  • 10% of organizations do not have a plan in place for conducting end-to-end testing, and 17% don’t have a clear idea when their organization will be ready to begin the lengthy and cumbersome testing process.
  • Among those who have no plans to test, more than a third cited a lack of knowledge as the reason they are stalled.  45% of those providers are clinics or physician practices that fall on the smaller end of the spectrum.
  • 35 % of providers believe they will take a hit to their revenue cycle from the new code set.  18% are unsure of how ICD-10 will affect their billings.
  • A whopping 27% of providers have not completed financial impact assessments, which is one of the first steps organizations should take in order to chart a course towards compliance.
  • Unsurprisingly, the majority of providers believe that coding will become more difficult under ICD-10, while 42% anticipate clinical documentation challenges.  41% expect that adjudicating reimbursement claims will be harder.
  • Barriers to implementation include changes to the clinical workflow and a loss of productivity (56%), inadequate staging, (49%) and effective change management (48%).  Just under half of providers are worried that their vendors and business partners won’t be ready on time.

The challenges seem especially daunting for physician practices than hospitals which probably reflects a lack of access to resources.  Across the board, a higher percentage of clinics and practices indicated that it would be more difficult to complete common clinical and administrative practices than acute care hospitals. 61% of clinics and physician practices believed that documenting patient encounters would be harder, as compared to 35% of acute care hospitals. Likewise, for adjudicating reimbursement claims, 54% of practices thought ICD-10 would make the process more difficult, versus 40% of acute care hospitals.