Friday, January 6, 2012

Survey Results: What do you want to know about ICD-10?

A few weeks ago I published a survey What do you want to know about ICD-10?  The purpose of this survey was to give readers a chance to help me pick topics for future blog posts.  Here’s some key information I gathered from the survey.  Thanks to all those who responded. If you provided an email address, I’ll send you a full copy of the results as soon as I can condense and assemble them.  Also, I’ll leave the survey up for those who might want to review its details and/or complete the survey.
Summary of Results
Twenty-two people took the survey. Based on my review of company names and email addresses provided at the end of the survey, it appears the clear majority of those who responded were healthcare providers.  There was also an Integrated Health System, 2 billing companies, 1 EDI switch and 4 respondents that I couldn’t identify or who didn’t provide identification information.
The following are some select responses to 3 open-ended questions:

1. What are your biggest concerns about ICD-10 compliance?
  • Vetting out a robust project plan for clinical aspects of the transition such as quality reporting and any performance improvement initiatives that can be lumped under the ICD-10 umbrella.
  • Getting physicians to document with sufficient specificity to allow ICD-10 coding.
  • Revenue loss due to coding and documentation.
  • CDI - Getting Physicians trained to be more granular in describing/documenting the case.
  • Quantifying financial impacts.
  • Electronic transactions - PM/EHR, clearinghouse and payer readiness. Provider documentation and selecting the right ICD-10 code.
  • Dual use period.

2. Payers: If you were a 'fly on the wall' of your largest provider partners, what single conversation/topic do you think they are most concerned about?
  • Where they (providers) stand in terms of testing?
  • What are they (providers) doing about contract modeling?
3. Providers: If you were a 'fly on the wall' of your largest payer partners, what single conversation/topic do you think they are most concerned about?
  • How are you expecting your case management procedures, pre-admission authorization, and pre-payment review procedures going to change?
  • How they plan to maintain financial neutrality?
  • Will they cross check CM with PCS and deny claims based on linkages and 'lowest reimbursement' procedures?
  • How the payor will try to pay providers less?
  • Will you be ready six months prior to October 2013 and will you be creating more ways to deny our claims. If yes, how can I avoid denials?
  • What are they doing about contract modeling?
The remaining survey items were multiple choice options.  I’ve selected the top two most frequently selected options from each category.
4. Most frequently selected “assessment-related” topics:
·         Approaches to Identify & Inventory Business Process Impacted By ICD-10
·         Identifying, Communicating, Managing & Validating Impact of External Entities
5. Most frequently selected “coding/information-related” topics:
·         Business Processes and Applications Impacted by ICD-10 and Related Codes
·         Overview of other codes Impacted by ICD-10 including DRG’s, MDC’s, and HCC’s
6. Most frequently selected “design-related” topics:
·         Considerations and Impacts Related to Dual Processing of ICD-9 & ICD-10 codes
·         ICD-10’s Impact to Medical Policy, Care Management & Disease Management Programs
7. Most frequently selected “financial-related” topics:
·         ICD-10’s Potential Reimbursement Impact Including DRG Shifts and Changes in Case Mix Index
·         Clinical, Operational & Financial Neutrality: Medical Loss Ratio, Predictability & profitability
8. Most frequently selected “tool-related” topics:
·         Methodologies, Best Practices, Checklists, Tools and Templates
·         Currently available Mapping, Crosswalk and General Equivalency Mapping (GEM) Tools and Services
9. Most frequently selected “ICD-10 strategic-related” topics:
·         Leveraging ICD-10 Investment beyond October 2013
·         Opportunities, Issues and Risks Associated with ICD-10’s Impact to Longitudinal Data Analysis
Next Steps
Over the next few weeks and months, I will begin iterating through the above list, share my knowledge and provide my take on the items of most interest to those who completed the survey. I have a lot of knowledge and experience on many of these topics; not so much on others but I’ll do my best to research and share what I can learn about all of them.
Thanks again to all who responded!

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