Thursday, October 13, 2011

Going Beyond Simple ICD-10 Compliance – Think Strategically!

I suspect many, if not most, healthcare payers will struggle to meet the October 1, 2013 compliance date.  But there will be a small percentage of payers initiating other programs in tandem with their migration to ICD-10 – similar to how some providers may bundle their movement towards meaningful use with their ICD-10 compliance activities.

Here are some strategic initiatives that forward-thinking payers may undertake with their ICD-10 assessment and compliance project – if not simultaneously as they march toward the compliance date – certainly shortly thereafter.

1.      Improve care management programs
2.      Improve business intelligence and data analytic capabilities
3.      Creating provider contract models and consider re-negotiating certain contracts
4.      Reconfiguring member benefit plans
5.      Creating new payment models based on performance and value (like P4P, VBR, etc.)
6.      Deploying or enhancing patient portals and member engagement tools
7.      Designing new member wellness and lifestyle programs

All of the above are enabled by the increased specificity of ICD-10 codes. In my estimation, items number 1, 2, and 3 can provide huge returns for payers approaching ICD-10 in a more strategic manner.

What other programs and improvements do you think will be enabled by ICD-10?

1 comment:

  1. I believe Payors will be fine compared with Providers. Most of the Providers needs to initiate ICD-10 efforts. I am concerned about Providers than Payors as i have seen Most of Payors already started ICD-10 preparation in a big bang way..

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