Now that the new year is officially in full swing, many healthcare organizations are realizing that in less than nine months, ICD-10 will be upon them whether they are ready or not.
A Workgroup for Electronic Data Interchange survey published in mid-December found that around 80 percent of participants have not begun testing and only about half have taken the initial step of conducting an impact assessment.
[See also: ICD-10 delay finalized]
Healthcare Finance News talked to some industry experts to find out where organizations are in the run up to Oct. 1.
Up until now, the majority of healthcare organizations have been focusing on the technology side of the ICD-10 transition and have concentrated their resources on planning and implementing all of the required system changes, said Chris Edell, CEO and founder of healthcare consulting company Elevar, and Alek Bituin, the company's corporate development lead.
"We're beginning to see more and more providers focus on the 'people' side of the transition, which involves developing training sessions and tools for every level of the organization that touches ICD-10," said Bituin. As organizations complete their testing with external partners, they are shifting to internal readiness, which means they have to begin developing and implementing training programs for physicians, billing, insurance verification and other workers.
Training staff is where Conemaugh Health System in Johnstown, Pa., is putting its focus now.
[See also: ICD-10 contributes to healthcare industry's 'evolutionary process']
Conemaugh began preparing for ICD-10 in April 2013, said Renee Monahan, vice president of revenue cycle. The health system worked with hired consultants to help prioritize the service lines that had the most opportunity for documentation improvement under ICD-10 and sent four key coding leaders (directors of hospital and physician division coding, hospital inpatient and outpatient coding managers) to ICD-10 Boot Camp to become ICD-10 AHIMA certified.
Those four leaders, including Bonnie Roane, director of Conemaugh Physician Group, and Marissa Bazyk, director of HIS and reimbursement, came back with extensive knowledge that they are working on teaching to their coding staff, as well as the physicians, said Monahan.
"We're trying to figure out how to best educate our physicians, coders, billers, registrars – pretty much everyone in the system will need to be educated at some point," Bazyk said.
"Basically, we have been deciding which educational modules we'll use and how to structure them," Roane added. "We want to know what's important to the physician to make sure they are engaged and ready for when the time comes to begin coding."
While Conemaugh is ahead of the curve on ICD-10 preparation, most are not, Edell and Bituin noted. They said that through their work with various healthcare organizations and conversations with executives, it seems that there's a high level of fragmentation in ICD-10 preparedness across provider networks.
"Hospitals with thin or negative operating margins, especially in rural regions, have struggled to invest the necessary resources to prepare for the ICD-10 transition, which will only exacerbate their operating margins in the years ahead," said Edell. "Profitable hospitals with robust operational resources have typically been much more successful in the preparation effort."
One thing healthcare providers need to keep in mind, Bituin added is that the impact of the coding changes on payers as they adapt to ICD-10 will potentially rebound on their claims processes and outcomes.
"The focus has been on the providers and clinicians, but, in the end, the real impact is going to be felt on the payer side," he said.
[See also: ICD-10 compliance: 8 lessons from Canada that can help you plan]