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Survey Reveals ICD-10 Readiness, But Concerns Remain

June 26, 2014
by Rajiv Leventhal
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While the majority of organizations are ready to begin testing for ICD-10, 45 percent of respondents don’t have a good sense of their partners’ readiness, according to a new survey conducted by eHealth Initiative (eHI) and the American Health Information Management Association (AHIMA).

The survey, which was sponsored by Edifecs, a Bellevue, Wash.-based global health information technology solutions company, revealed that a majority of healthcare organizations impacted by the mandate are using time afforded by an extended compliance deadline to invest in clinical documentation improvements, workforce training and partner testing, yet concerns over readiness and financial impact remain. Despite the challenges in the short term, most expect the more specific code set to return value in the long run.

Key preliminary findings from the survey include:

• Most organizations are prepared to begin testing in the near future. Forty percent of respondents reported they would begin end-to-end testing by the end of 2014, and 25 percent reported plans to begin by the end of 2015. Of those who stated they had no plans for end-to-end testing, however, 41 percent stated they had no knowledge of how to perform testing.

• Widespread concern about the impact of ICD-10 on workflow, productivity and revenue. Thirty-eight percent of respondents reported they believe revenue will decrease, while 14 percent believe revenue will remain neutral. Only six percent believe revenue will increase.

• Optimism that increased specificity can improve research, population health management and quality/performance measurement and improvement. Respondents answered that common activities such as coding patient encounters, adjudicating reimbursement claims and negotiating contracts between health plans and providers are expected to be more difficult in the short term. Although the long-term impact of the ICD-10 transition is expected to improve care in areas such as accuracy of claims, quality of care and patient safety, not all organizations have a clear plan to derive value from the expanded code set.

• Extensions represent an opportunity for additional training. In order to mitigate productivity loss, 68 percent of respondents stated they plan to conduct additional training and practice, and 31 percent plan to hire more coders to assist with the transition. More organizations are also taking advantage of the compliance transition by training more staff for ICD-10 and improving clinical documentation integrity.

• Clinical documentation integrity is expected to be more difficult. Respondents indicated the task that is expected to be the most difficult post ICD-10 transition is clinical documentation improvement, particularly documenting and coding patient encounters. About 61 percent of respondents report planning to utilize the extension to improve clinical documentation integrity.

• Organizations expect to leverage increased code specificity for claims processing and billing, performance measurement and quality improvement. Respondents stated they plan to leverage the more specific code set for claims processing and billing (65 percent), quality improvement (62 percent) and performance measurement (51 percent).

Survey respondents included vendors, payers, clinic and physician practices, acute care hospital representatives, consulting firm representatives among others. The survey, to date, was distributed to a variety of stakeholders in May/ June 2014 and returned 349 responses.

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