March 5, 2013

ICD-10: “On the Grind”

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The Urban Dictionary defines “on the grind” as meaning to work hard, and to always be hustling.

We’re finding that almost all of our clients are “on the grind” when it comes to ICD-10, meaning that active remediation program work (i.e. post-assessment work) is either in full swing or gearing up. This has some profound potential short- and long-term implications for ICD-10 stakeholders.

1)    A supply/demand imbalance is coming.

Our ICD-10 practice’s business grew about 15 percent last month alone. We see no abatement in the coming months, either. With the implementation date now fewer than 20 months away, ICD-10 program teams are growing to their peak resource levels for a major remediation push. We all know that there is a finite set of healthcare resources available to perform this work, and the demand, during the next 12 months in particular, will exceed supply dramatically. In my first hour of my first Economics 101 course, we learned the immutable laws of macroeconomics, and what happens when supply is finite and demand is increasing for price-inelastic goods and services. Expect escalating rates for supporting resources in the coming year.

2)    You may want to think about the timing of your training initiatives.

You neither want to train too early nor too late. While philosophies vary, most want to train the bulk of their ICD-10 trainees three to six months before the implementation date. The conventional wisdom in this case indicates that if you train earlier, staffers’ skills will atrophy before they start using the new coding system, yet if you train them later, they won’t have sufficient time to learn. However, if everyone chooses to train their staffs in the same three-to-six month window, there won’t be sufficient qualified trainers available to meet demand. Our advice is to complete your training strategy and lock in your future training resources as quickly as you can.

3)    Analytics, reporting and interfaces are jumping to the forefront.

Most ICD-10 strategies and roadmaps focus heavily on core transactional systems and give lip service to analytics, reporting and interfaces, with many of our clients thinking (Hoping? Praying?) that their core systems vendor will solve ICD-10 for them. Yet our clients are starting to realize what we’ve been saying for some time: the core transactional system implementations are large, difficult projects, but they are not where you need to spend time deep in thought. Analytic strategy (especially trending), interfaces and data migration now are keeping ICD-10 practitioners up at night, and appropriately so.

4)    “Murphy” has reared his ugly head for some.

Murphy’s law (what can go wrong, will go wrong) is coming into play for many healthcare companies. Even the best-laid plans to upgrade and/or replace major systems are not going so well, and some major system implementations/replacements are projected to last beyond the timing required for testing to meet the Oct. 1, 2014 implementation date. Some of our clients that strongly rebuked “step down/step up” insulation strategies now are being forced to rethink their strategy and adjust mid-course. The process, resources and cost implications could be extreme for some of these companies.

As tens of thousands of healthcare professionals go slightly “off the grind” and migrate to New Orleans for the Healthcare Information and Management Systems Society (HIMSS) 2013 Conference, we anticipate a lot of the ICD-10-oriented discussions to focus on these topics.

If anyone feels like engaging in a healthy debate about any/all of these topics over a hurricane at Pat O’Brien’s, count me in!

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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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.