Hospitals Are Increasingly Outsourcing ICD-10 Preparation

While approximately half of US hospitals will be ready to implement ICD-10 coding, education, IT solutions, managed services partners, staff training, and cooperation, many are looking to outsource their preparation.

The number of hospitals contracting for external clinical documentation improvement (CDI) services before the new Oct.1, 2015, deadline could triple, according to a new survey of 650 hospital technology and physician leaders from Black Book.

Currently, a quarter of hospitals outsource their clinical documentation audit, review, and programming, but according to the “Top Ranked Clinical Documentation Improvement Vendor” report, by the third quarter of 2015, 71% of hospitals plan to have a CDI partner. In 2013, just 15% outsourced for CDI. Hospitals are looking to outsource this work in order to help them adjust and survive under the new codes.

“There is no bigger provider opportunity on the horizon to maximize financial health than to improve the accuracy of provider clinical documentation,” Doug Brown, Managing Partner of Black Book said in a statement.

According to Black Book, 88% of hospitals with 200-plus beds that are currently outsourcing CDI reported to have realized gains of more than $1 million in appropriate revenue and proper reimbursements because they implemented a CDI program.

Other services that are being increasingly outsourced by US hospitals include coding, which will increase 265% to more than half of hospitals in 2015; medical imaging, which will increase from 14% in 2014 to 18% in 2015; and transcription services, which increases 11% to 70% in 2015.

The only coding-related outsourcing that is not increasing is ICD-10 education. Next year 46% of hospitals plan to outsource it, which is down from 54% in 2014.

“Transitioning to ICD-10 is a complicated process and hospitals are leaning on the expertise and successes of outsourcing vendors,” Brown said. “We still operate in an ICD-9 world, complicated by EHR implementations, value-based reimbursement models, compliance issues and optimizing reimbursement; a perfect storm from which outsourcers have the expertise to shield their clients.”