ICD-10 coding, accountable care organizations, EHRs top industry issues in 2011

December 28, 2010

Major investments in health information technology (HIT), helping patients understand and navigate their way through changes associated with healthcare reform, adaptations to your practice to align with accountable care organizations' (ACOs?) payment models, and decreased business as consumers watch their wallets are among the Top Health Industry Issues for 2011 identified in the annual list by PwC's Health Research Institute.

 

Major investments in health information technology (HIT), helping patients understand and navigate their way through changes associated with healthcare reform, adaptations to your practice to align with accountable care organizations' (ACOs’) payment models, and decreased business as consumers watch their wallets are among the Top Health Industry Issues for 2011 identified in the annual list by PwC's Health Research Institute.

The amount spent on HIT in 2011 is expected to exceed the more than $88.6 billion providers spent in 2010. According to the report, providers should be focused on compliance issues related to electronic health records (EHRs), ICD-10 coding, and HIPAA 5010 transactions to best meet patient needs and provide better care.

And, as providers continue efforts to implement EHRs, the government is mandating that hospitals and providers complete at least one stage of the "meaningful use" criteria. The first stage involves providing patients, upon request, with electronic copies of health records-something that just 14% of consumers are currently doing.

Helping patients understand the healthcare changes is another challenge. Fewer than half of patients polled by PwC know what an EHR is. There is a similar lack of awareness about health information exchanges (HIEs).

ACOs present a two-sided concern. Practices will need to make changes in the way they provide care to streamline costs and improve outcomes. And, while adjusting to adhere to new payment guidelines, providers will also have to find ways to maintain their volume of non-ACO patients.

Increased deductibles many patients will have to pay beginning in 2011 are another concern. Deductibles of $400 or more could cause patients to be more selective in their care and less adherent with medication, and fewer visits can of course lead to reductions in tests and labwork. However, patients may also be more inclined to visit for preventive care.