October 16, 2012

Help Me Help You – And I’ll Show You the Money

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Most healthcare organizations recognize that they have to know more about what their vendors, trading partners and providers are doing to get ready for ICD-10 – and what will affect their readiness.

Information you must get from those entities includes their project plan statuses, which IT systems they use, and when they think they will be ready for testing. You can pair this information with data you already have (metrics indicating claims volume, type of provider or specialty, claims complexity, etc.) to manage your testing strategy, to form contingency plans and to report to senior management what is really happening with ICD-10.

Impressions Count

There is a marketing rule of thumb that it typically takes seven impressions to engage a prospective customer. Of course, there are a lot of variables affecting this, but the basic premise is sound. If you want someone to take action, particularly when using a low-touch (and low-cost) approach like email communication, it will take a concerted effort to get the results you want.

Getting information from these third parties often is easier said than done. You have to deal with a large and dynamic collective that may think that Oct. 1, 2014 is a long way away. For ICD-10 program managers who have concluded that it is important to engage their affiliates (vendors, trading partners and providers) regarding ICD-10, there are some important principles that can help you get the results you want.

Sticks vs Carrot

You can use sticks instead of carrots on some of your affiliates. Vendors and trading partners recognize the importance of their relationships with their customers and will respond to stern warnings. Communications including phrases like “mandated to maintain your status” or “a requirement to continue to do business with” will get a response.

Working with Providers

You likely will have to treat providers differently. As the saying goes, I can’t make you do it, but I can make you want to do it. Most of the surveys conducted by the Workgroup for Electronic Data Interchange (WEDI) and the Centers for Medicare & Medicaid Services (CMS) indicate that providers are behind in terms of where they should be in preparing for ICD-10. Health plans recognize that it is in their interest to minimize problems with ICD-10 by being proactive about testing.

In the 1996 movie of the same name, sports agent Jerry Maguire urges his football player client to “help me help you.” That has to be the basis for your stance, particularly as it pertains to your providers. You may need information from providers to make your testing program more efficient and better understand the nature and severity of risks, but your providers don’t care about that.

There are a number of ways that you can “help them.” Feedback is one way. Because you will have surveyed their peers, you can provide them with their status relative to their peer group. This is valuable, particularly for those who are lagging behind and may not realize it. Coaching is another area where you can help them. If they are lagging, tell them what they should be doing. Direct them to the relevant ICD-10 best-practice model from their professional organization, like the American Medical Association (AMA) or the American Health Information Management Association (AHIMA).

You need to communicate why it is important that you know about their ICD-10 readiness and dependencies. Unless you know these things, you can’t really help them. The other famous quote from Jerry Maguire is “show me the money.” Providers are concerned about reimbursement. The better prepared they are for ICD-10, the less likely there will be reimbursement problems. This is the strongest argument you have to gain their cooperation.

Help me help you, and I’ll show you the money.

About the Author

Hugh Kelly is the
 Vice President of Marketing and Sales for Avior Computing. 

Mr. Kelly has more than 20 years in the software and technology business at organizations ranging from start-ups to publicly traded companies. Mr. Kelly has been involved in all aspects of marketing and sales, with considerable focus on channel development.  During his executive tenure, his organizations have raised over $200M in external capital.  He is a venture partner at Ascent Ventures.

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Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.