Physicians, Payers Largest Hurdle for ICD-10 Readiness

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.

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.