Taller provided some insight into what these responders and others are thinking about instead. Specifically, “People are still trying to figure out what they need to do from a testing perspective and from an ICD-10 readiness perspective.”
These guests on Wednesday’s Talk-Ten Tuesday broadcast also filled in a few of the blanks.
- Maria Bounos, business development manager for regulatory and reimbursement software solutions for Wolters Kluwer Law and Business
- Tom Ormondroyd, vice president and general manager of Precyse Learning Solutions
- Susan Gurzynski-Wells, solutions executive, ICD-10 and revenue cycle at HealthStream
Help on the Way
Taller discussed the presentation she and her colleagues gave at the HIMSS conference about The HIMSS/WEDI ICD-10 National Pilot Program, which, according to its dedicated website, was established to “assist the healthcare industry in its efforts to prepare for ICD-10 testing and to share best practices from early adopter organizations” (http://www.himss.org/library/icd-10/national-pilot-program?navItemNumber=13477). Program participants include providers, health plans, vendors, consultants, associations, government and many others.
They presented the need for, and scope of, this national pilot program, the challenges and goals being faced, work groups being established, and other “things that the pilot needs to successfully move forward.” And move forward is exactly what is happening as the pilot now has 90 organizations and 218 individuals participating.
The findings, which will include best practices for testing, will ultimately be available online and free of charge for use by the general industry in the HIMSS ICD-10 PlayBook. The overall goal of the pilot, Taller says, is to “provide guidance and resources, build collaboration by sharing ideas, and enhance the efficiency of the testing process.”
Identify Payment Changes
Enhancing efficiency also includes predicting the payment impact of ICD-10, which Maria Bounos addressed.
“We are helping providers look at their current business models under I-9 and simulate to I-10. We talk about methodology behind it, which includes taking the expected Medicare payment, doing a simulation study, looking at MS-DRG payment and drilling it down to MDC, major service line, winners and losers, etc.”
Bounos gave a case-study example of one service line. “We’re showing the five top MDCs: respiratory, musculoskeletal, endocrine, digestive, and the eye. Those were some of the areas negatively impacted and, not surprisingly, also cardiology,” she said. “We drill it down by DRG and show the negative impact for procedures like cardiac defib, implants, vascular procedures, etc.”
Education Expands to Physicians
Tom Ormondroyd summarized his presentation at HIMSS, which focused on how to provide comprehensive I-10 education for the impacted population. As he says, “This year there is a greater awareness that it’s more than coders.”
Education must also be provided for physicians and others in the revenue cycle, and there are “myriad approaches” that can be used. For example, people want to know what technology is available to unlock ICD-10, and, according to Ormondroyd, most HIMSS attendees are asking about on-demand, online education, in particular for physicians.
As he explains, it’s difficult for a facility manager to get all physicians in the same room because their schedules vary so widely. To reach them, a more interactive, accessible approach must be used instead of the “old-style classroom,” he says.
Susan Gurzynski-Wells agrees with Ormondroyd that there is “genuinely more awareness and greater urgency than six months ago. There’s an interest in education and flexibility, such as mobile content, to attract different learners. There’s also more interest coming from physicians, who know they need the education and are embracing it more. They are asking questions as to how it affects them.”
She is “surprised” by the high level of individual research that providers are doing and says that they are asking more “intense” and focused, individualized questions such as “What makes your company the best?” and “What solution will be best for my facility?”
