May 19, 2014

At a Loss for Words

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I know many ICD10monitor readers personally; some are clients, some are colleagues, some are friends, and some are competitors. If you are in one of these groups (and I like the clients, colleagues, and friends), you know that I often have a lot on my mind and I generally talk way too much.

Yet at this point in time, in regard to ICD-10 I’m pretty much at a loss for words, and struggling mightily to meet my article-a-month obligation to the inimitable and persistent publisher, Chuck Buck.

The truth is, right now I have very little to say about ICD-10 that’s not already been said (“the delay is an opportunity,” “stay the course; don’t pause,” “slow the burn, but keep core teams intact,” “eat lots of fruits and vegetables,” etc.).

It’s a rather dull period with not much action we’re currently mired in, as our clients and prospective clients are rejiggering their program plans and wondering what ongoing efforts will be approved, which will be stalled or paused or changed, and which will be ended altogether. 

It’s worth noting that we’ve been pleasantly surprised that our clients for the most part are continuing to move forward with ICD-10 program work in earnest.

When the delay was passed by Congress and enacted by the president, we anticipated a 20-30 percent reduction in our ICD-10 business within the first month or two. This has not been the case, however. We have seen about a 5 percent reduction in our overall ICD-10 business and had a few projects that were about to start go away abruptly. In fact, we recently inked a rather large provider testing engagement with a payer client that feels as though engaging with providers during the extra year of remediation represents a real opportunity. 

We anticipate that once the re-planning and re-budgeting activities are complete, our workload will likely increase in some areas. Fortunately for us all, the Centers for Medicare & Medicaid Services (CMS) has alluded to the new mandated date, so planning can finally be consummated with some sense of certainty. In the new and revised program plans, we believe that clients will increase investments in areas such as:

  • Custom mapping development
  • ICD-10 financial testing and analysis (e.g. DRG shifts) to re-baseline
  • ICD-10 system remediation for laggards
  • ICD-10 system remediation for applications that were not going to be remediated due to time constraints (e.g. systems that were going to be “wrappered” with a “step-down/step-up” architecture while the provider continue to utilize ICD-9)
  • ICD-10 clinical documentation improvement programs
  • ICD-10 physician engagement and education

We’re hopeful that the relative malaise of this spring will lead to a pretty active summer for most ICD-10 programs and that, in about nine months (give or take a month or two), activity levels ultimately will eclipse those from the period before the most recent delay was announced (and this period was quite active for the entire industry).

In the meantime, I’ll be in an existential search to find something meaningful to talk about – and seeking inspiration.

About the Author

John Wollman is the executive vice president of healthcare for HighPoint Solutions, a management and information technology consulting firm focused on healthcare and life sciences.  John is responsible for HighPoint’s healthcare industry group, catering to payers and providers.  John is a recognized expert in several healthcare business domains (Reform, HIPAA 5010, ICD-10, Platform Strategy) and technical domains (Master Data Management, Analytics).  Since graduating from Duke University, John has held executive level positions at consulting and technology companies over his 25 years in business.

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