Monday, July 30, 2012

6 Considerations for Choosing Your ICD-10 Services Partner

If you’re a healthcare organization faced with the ICD-10 mandate and haven’t already engaged outside assistance with your assessment and remediation project, you must certainly be in the process of doing so.  Here are six considerations for choosing a partner to assist with your ICD-10 project.

1.       Payer Expertise vs. Provider Expertise?
There’s little overlap between the applications and business processes used by a healthcare payer vs. those used by a healthcare provider. Likewise there’s a gap between the apps and processes used by an institutional/hospital provider vs. those a professional practice. These differences should influence the partner you select.
2.       Does Size Matter?
While some firms mandate preferred consulting partners of the Big 4 genre, ICD-10 services are specialized, the pool of qualified resources is rather limited and quality resources are not easily grown. While there is no doubt Big 4 firms can perform, some niche firms or even a group of affiliated consultants could offer quality and value equal to or even better than the Big 4 types. Remember that bigger is not always better – but almost always the most expensive.
3.       Partner vs. Senior vs. Junior?
Which consultants are actually going to be assigned to your project? While you can’t expect, or even need, your effort to be staffed solely with senior-level resources, your contract should specify the exact resource types and time commitments assigned to your project.  Resumes for each would not be an unreasonable request. The last thing you want to be doing is paying a healthy rate to train your partner’s junior resources only to risk them bolting before your project is completed.
4.       Ours, All Ours!  Or Sure, We Can Share!
Often there’s a clear chain of command requirement, financial or functional benefit to engage a single consulting firm to provide all services needed. Other times there could be some benefit to parceling out certain aspects to different firms – especially aspects of testing, training and validation. I suggest you explore this option early on.
5.       On-site, Remote or a Healthy Mix of Both?
It may not be in your firms best interest to have all work performed by your consultants on-site. Consider the type of work being done, the potential negative impact to your staff having consultants around your office and travel expenses; chances are you may get a better quality outcome at a lesser cost by considering a mix of on-site and remote working arrangements.
6.       Tools & Templates or Time & Expense?
An often overlooked aspect of engaging a consulting firm is having a clear understanding of the tools, templates and frameworks they’ll bring to the table and use to expedite your project.  You probably want to avoid having consultants build tools at your expense – unless there is some clear benefit of re-use, ownership, etc. Be sure to understand any additional costs that may apply.
So What’s the Best Approach?
All of the above considerations are inter-related and each firm has its own unique needs for ICD-10 services. Moreover, ICD-10 can be considered a Vujà dé event: You’ve never been through this before and neither has anyone else.
But what would I think is an ideal situation if I was an institutional provider looking to engage outside services?
A consulting firm specializing in hospital systems that's not too big or too small charging a reasonable hourly rate and who’s assigned a partner to oversee a reasonable ratio of senior to junior staff using a hard drive full of templates and tools working in harmony with your staff and other external specialty vendors. 
Good luck with that! (And who cares what I think?) 


  1. I feel like I'm missing something here; wouldn't it make sense for government and the insurance industry and provider groups like AMA work together to create translation tools and training and a whole corp of available talent (think unemployed IT pros and others who would easily take to needed training) to make this huge conversion easier ans smoother for everyone?

    Or am I just being silly?

  2. R Troy...

    Great idea! Of course that would make sense. But not cents for those promulgating this cluster f&%$ of a mandate.

    I'm sure other may call be naive but I bet a couple hundred million spread across a number of intelligent, hungry, "non-corporate aligned" business and IT people organized by a "non-profit" could develop a toolbox full of software to share among the masses. But that sounds sorta smart so don't expect it to happen.

    Isn't that what all these 'standards organizations' were suppoed to be doing for the last decade?


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