April 2, 2013

March Madness and ICD-10: Is it Possible to Bracket it?

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It’s March Madness time, and many men’s college basketball teams have worked very hard to get to the Sweet 16 of the NCAA tournament and beyond. Unfortunately, as with all things there will be winners and losers – and for all but one lucky squad, there will be great March Sadness.

I was quite shocked with the craze these last few weeks and how some people actually take a week off to focus on their brackets! As I learned this, I could not help but ask: why can’t healthcare professionals put this type of energy into ICD-10? Maybe we should make an ICD-10 bracket!

Seriously, I have spoken to many in the industry, looked at numerous polls, and read up on current surveys – and no one is moving very fast as it relates to the implementation of ICD-10. But why not, when we only have 18 months until implementation? I bet if we “bracketed” ICD-10 we’d get more interest, more rigor and more strategies toward successful implementation.

The most recent article on this topic I’ve read was one published by iHealthBeat on March 13 titled “How Far Along is your Healthcare Facility in the Process of Converting to ICD-10 Code Sets?” The groups surveyed by Aloft Group, a brand strategy and marketing firm, included executives, clinicians and other professionals in the healthcare setting. The survey revealed that 33.8 percent of respondents have not started their implementation preparations; 40.8 percent had completed 25 percent of the process; only 18.8 percent were half complete; 5.8 percent were 75 percent complete and .8 percent were 90 percent or more complete. The results of this survey were in line with those of some of the polls posted on Talk Ten Tuesday, ICD-10monitor’s live weekly podcast, during the last six months. The polls and survey both point to the fact that the industry has not really moved at all in that period, with approximately 8o percent of the industry still stuck in the assessment and planning phases of ICD-10 implementation!

One of the factors that contribute to lack of motivation is that many organizations have had to reprioritize due to the many mandates tied to penalties and the inability to free up resources. The No. 1 obstacle that I hear over and over again is the lack of physician cooperation (and also the brutal reality is that the implementation of ICD-10 is costly!)

Implementation is so costly, in fact, that some budgets more than doubled while still in the assessment phase; with some larger integrated HC systems, budgets ballooned by more than four times. On average, ICD-10 will cost $1 million to $5 million for a typical facility, and up to $20 million for a large, integrated delivery model. While by and large these are conservative numbers in nature, it is important to note that revenue losses can last up to one to two years on average, post-implementation.

So if I wanted to “bracket” the various factors for successful ICD-10 implementation, I wouldn’t put money on any one being the “winner,” as every organization is different and various factors will affect various processes. For this gal, all bets are off, specifically as it pertains to the financial implications noted above.

About the Author

Maria T. Bounos, RN, MPM, CPC-H, is the Business Development Manager for Regulatory and Reimbursement software solutions for Wolters Kluwer. Maria began her career at Wolters Kluwer as a product manager, responsible for product development, maintenance, enhancements and business development and now solely focuses on business development. She has more than twenty years of experience in healthcare including nursing, coding, healthcare consulting, and software solutions.

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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.
Maria Bounos, RN, MPH, CPC-H

Maria T. Bounos, RN, MPM, CPC-H, is the practice lead for coding and reimbursement software solutions for Wolters Kluwer.  Maria began her career at Wolters Kluwer as a product manager, responsible for product development, maintenance, enhancements and business development and now solely focuses on business development.  She has more than twenty years of experience in healthcare including nursing, coding, healthcare consulting, and software solutions.