An ICD-10 post-implementation survey from the Reston, Va.-based Workgroup for Electronic Data Interchange (WEDI) has revealed that the transition to the new coding set has generally gone well for organizations, although the latest assessment had a low participant response rate.
WEDI has been conducting ICD-10 readiness surveys since 2009 to gauge the status of industry implementation progress. On Oct. 1, 2015, the industry converted to ICD-10 in what some have called a non-eventful transition. In a February blog post, Andy Slavitt, Centers for Medicare & Medicaid Services (CMS) Acting Administrator, called the transition a success.
This most recent survey from WEDI had a low response rate, possibly indicating the reassignment of ICD-10 project personnel and likely a lack of interest in further ICD-10-related activities that are not operational in nature, according to the organization, which wrote a letter about these results to U.S. Department of Health & Human Services Sylvia Mathews Burwell on May 2. Indeed, the March 2016 survey got just 66 responses from health plans, providers, and vendors; previous WEDI ICD-10 surveys have gotten hundreds, if not a few thousand responses. Other notes from the latest survey include:
• Compliance date changes: While the changes to the compliance date added cost for many organizations, causing a lack of momentum, it also provided time for additional testing and a smoother transition.
• Key lessons: Some common themes reflected in the responses indicate the value of starting early, communicating with trading partners, and conducting extensive testing.
• Industry education collaboration: The CMS ICD-10 website, including Road to 10, the WEDI website and coding materials from industry organizations were cited as being the most helpful.
• Productivity: While the impact to productivity was primarily neutral for vendors and health plans, there was a slight decrease in productivity for providers.
In terms of level of readiness, health plan and provider respondents said they were ready for the compliance date, although one provider indicated they required outside assistance to perform some functions. One vendor respondent indicated they were not ready and still had not delivered all their products or services, according to the survey’s results. However, all sectors indicated the delays added cost and caused a loss of momentum. But, all sectors also indicated that the delays improved the ability to perform testing and resulted in a smoother transition.
Vendor and health plan respondents indicated that the cost of implementation was on target with expectations or was more than anticipated. One-half of provider respondents indicated that the cost was on target with expectations, but the other half of respondents were about equally split between the indication that it cost more or that it cost less than expected.
Regarding productivity, the majority of vendor and health plan respondents indicated the impact to productivity was relatively neutral. While some provider respondents indicated a neutral impact, the majority indicated productivity was slightly diminished, especially in the areas of coding and clinical documentation. Some providers also responded that the authorization and pre-certification functions were negatively impacted.
Vendor respondents indicated that the primary lessons learned were that they would not have slowed efforts during the delays and that they would have performed more external testing. The most often cited lesson learned by health plan respondents is that more extensive external testing would have been helpful. Provider respondents did not clearly indicate any particular item that might have been done differently, although a few indicated they could have worked more closely with their vendors.
Further, vendor respondents indicated that they did not expect to realize any return on investment (ROI) with ICD-10. Health plan respondents were split about equally between those that expected to realize ROI and those that did not, although one respondent indicated they had already realized some ROI. The majority of providers responded that they did not expect to realize any ROI, although two respondents noted an improvement in their case mix index.
“Based on the survey responses and other industry sources it seems the transition as a whole went very well and lessons learned could be leveraged for implementing future mandates. The low response rate to this survey may be a reflection that organizations have moved well beyond the implementation process and have settled into ongoing operations under ICD-10,” WEDI concluded.
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