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Physicians, Payers Largest Hurdle for ICD-10 Readiness

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While most physicians and payers didn't feel like they would have been ready to transition to ICD-10 in 2014, most hospital and health system revenue cycle leaders were confident they would have been prepared.

While most physicians and payers didn’t feel like they would have been ready to transition to ICD-10 in 2014, most hospital and health system revenue cycle leaders were confident they would have been prepared, according to a new survey.

In fact, a survey from the Healthcare Financial Management Association found the lack of readiness on the part of physicians and payers was the biggest hurdle revenue cycle leaders expected to face for a 2014 deadline. Nearly three-quarters of respondents said physician readiness and 58% named payer readiness as the 2 biggest challenges to achieving ICD-10 readiness by the 2014 deadline. The survey responses were collected just before the one-year (or longer) delay was passed.

(As of Thursday evening, the Centers for Medicare and Medicaid stated that the Department of Health and Human Safety expects to release a new rule in the "near future" that puts the new transition deadline at Oct. 1, 2015, according to Modern Healthcare and the Journal of AHIMA.)

While 71% said they were confident in their organization’s readiness for a 2014 ICD-10 transition, just 45% were confident in their vendors’ readiness, 22% were confident in their physicians and 14% in their payers.

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The delay, however, is beneficial since more than 40% of respondents admitted they did not have a testing plan in place with their top 3 to 5 commercial payers. The good news, though, is that most hospital had the majority of their financial/billing IT systems updated already.

Unsurprisingly, larger organizations are more prepared: many had established monitoring metrics in place to help them better understand the financial impact of ICD-10, according to the survey results.

Only 73% of respondents expected that by Oct. 1, 2014, their organizations would have metrics in place to monitor the impact of ICD-10 to their revenue cycle. Slightly more than two-thirds expected to have contingency plans to mitigate financial risk by the previous deadline.

Only 12% said they felt confident that they could estimate the financial impact of ICD-10 on reimbursement, and 8% said the same for cash flow.

At this point, just 44% of respondents said their organizations have delivered training to impacted staff and only 30% had begun dual coding in ICD-9 and ICD-10. However, 71% of respondents said that more than half of financial/billing systems have been analyzed for the ability to support ICD-10 codes.

When the survey was taken, just 37% said they had adapted EHR templates for ICD-10, while 60% planned to do so prior to Oct. 1, 2014; however, this was before respondents knew that the deadline was being pushed back for at least a year.

The survey went out on Feb. 14, and the ICD-10 delay was signed into law on March 31.


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