Preparing for ICD-10 has been organizationally disruptive, clinically distracting and expensive, so when the transition to ICD-10 was officially delayed by President Obama on April 1st, organizations across the country were impacted. Change management plans, enterprise-wide task forces and IT roadmaps have been in place now for months, if not years, representing millions of dollars organizations have invested to prepare for ICD-10. At first glance, the many consider the delay unfair for those who prepared to meet the latest timelines, and that it undermines agencies that promised no further delays and it sends the wrong message about being proactive. Despite the opinion of those who decry this most recent delay, it’s difficult to dispute that those who were prepared for 2014, should be even better prepared in 2015 and positioned to reap both clinical and financial rewards as a result.
Chances are high that organizations that were on a timely path for ICD-10 were also preparing for Meaningful Use Stage 2. This delay will provide separation of these two milestones, and some health systems may be able to benefit from it. Putting Meaningful Use in the rearview will allow additional time for the prepared to leverage the more detailed ICD-10 code set to deliver stronger care to targeted populations. ICD-10 codes by nature provide a more detailed look at clinical diagnoses and can also be used to examine patient populations more closely. Therefore, organizations with ICD-10 compliant IT systems will have the opportunity to fine-tune clinical workflows, treatment algorithms and care plans through data and analytics, without the immediate threat of a regulatory ‘perfect storm’ that is Meaningful Use combined with ICD-10.
For many institutions, theICD-10 delay will require additional investment in resources to maintain readiness. Task forces take people away from their day jobs, trainings cost money and change management takes time. All of these factors can impact financial performance in the short term. Organizations preparing for ICD-10 uncovered many revenue cycle deficiencies, such as computer assisted coding (CAC), charge capture and rules based automation that needed to be addressed. Gaps in revenue cycle management systems are subsequently being addressed with bolt-on and potentially subpar solutions. Organizations are implementing these short-term quick-fix solutions out of fear that additional disruption could negatively impact their readiness. With the delay, and because leading organizations have already defined their processes, they can now plan appropriately and focus on identifying best of breed IT and revenue cycle solutions that align more strategically with their long-term revenue cycle goals.
Before the President’s decision, many organizations were bracing for a regulatory ‘perfect storm’ of ICD-10 and Meaningful Use. Now, organizations can be proactive and work to improving clinical workflows through data and analytics and identifying populations of patients they can better serve. The implications are clear: the prepared will have opportunities to make significant strides towards stronger population health management and to prepare their revenue cycle system and processes for value based incentives associated with ongoing payment reform.