With the threat of significant reimbursement losses, hospitals and health systems are feeling the pressure of getting the transition to ICD-10 right.
At HIMSS14 on Monday, conference attendees learned how one of the country’s largest Catholic health systems are handling the move to ICD-10.
CHE Trinity Health is the product of a recent merger of two large health systems, and with ICD-10 implementation under way at both organizations, leadership decided to continue with separately established plans, said Cynthia Fry, the health system’s vice president of revenue excellence.
“We’re collaborating on go-live support, cash-flow modeling and staffing remediation,” Fry said.
CHE initiated its transition project in 2010, Fry noted, with a capital budget of $3.1 million, including Computer Assisted Coding, and an operating budget of $4.2 million.
“We wanted to install CAC to offset anticipated ICD-10 productivity declines, and we used ICD-10 to get funding for CAC,” she said. “We tried to utilize things that were already in place, like existing interfaces, and we’ve had good results.”
CAC is currently live at five hospitals, and has reduced coder backfill spend by over $1 million and increased coder productivity by 15 percent. Coding-related denials are down and quality has increased.
Clinical documentation is one of the most critical pieces in preparation for ICD-10, said Howard Walker, CHE Trinity Health’s director of program excellence. The health system installed a clinical documentation improvement system (CDIS) integrated with the CAC solution to utilize electronic documents, natural language processing and query suggestion.
“ICD-10 ready queries are in use well in advance of the deadline,” Walker said. He added that other hospitals should be able to evaluate their CDI program and shift to ICD-10 ready queries before Oct. 1.
“If resources are limited, you could contract with an outside firm,” Walker said. “But if you have the skill set you can keep it in house.”
Other key steps in the transition process were a workflow analysis and a reimbursement analysis.
“We thought we had a huge risk in workflow,” Fry said. “So we created our own electronic survey for department managers to determine their needs. That’s a big help in highlighting problems that might otherwise fall through the cracks.”
All told, Walker said, the health system has saved over $1.5 million and feels pretty confident as it bears down on the Oct. 1 deadline.