News

June 23rd, 2014

Staying the Course on ICD-10 Will Bring Immense Benefit

What is the best course of action after ICD-10 has been delayed by a year?

Source: Advance ExecutiveInsight

After President Obama signed the "doc fix" act on April 1, there was immediate disagreement among health information professionals about whether delaying the ICD-10 transition was good or bad. Some say it will allow breathing room in their preparation process, while others say it will negatively impact resource and budget allocation. Timing aside, what seemed to get temporarily lost in the discussion were the gains to be made following a successful transition. A glass half-full perspective is in order.

Despite the delay-which has been settled by law, making the good/bad debate a bit academic-the transition to ICD-10 has merely been postponed, not killed. The only thing that changed for health information professionals is the due date.not the assignment. And transitioning to ICD-10 was always about something much more important than meeting a deadline.

Here's the glass half-full part. Yes, the sheer number of codes in ICD-10 adds complexity to clinical documentation, and it's tempting to take a pause. Yet it is precisely the new code set's level of detail that enables health information professionals to take a vital role in transforming healthcare, at both the provider and national levels, making staying the course imperative.

For providers, ICD-10's precision in health information will support a suite of performance improvement across operations:

  • Patient care outcomes. ICD-10 will enable far more exact measurements in care quality, safety and efficacy, ultimately paving the way to improved clinical outcomes for individual patients and, ultimately, whole populations.
  • Resource utilization. Administrators will be able to more precisely track the amount of time required for virtually any procedure, and therefore more effectively plan resource allocation.
  • Payer requests. Claims will include greater specificity, reducing the need for payers to request such follow-up information as copies of medical records, in turn reducing costs.
  • Financial outcomes. More detailed claims should also improve payment accuracy and reduce rejections due to coding issues.
Furthermore, ICD-10's information precision extends beyond individual providers to touch the cornerstones of our national health system:

  • Care innovation. With no room for new codes, ICD-9 limits the ability to code innovative procedures and techniques. ICD-10's expansive coding is much more suited to supporting medical advances.
  • Life sciences research. By more precisely classifying conditions and associating them with causes, treatments and outcomes, ICD-10 will open new research opportunities, including international research that extends to the many countries already using ICD-10.
  • Health policy. Far more precise data analytics can prove to be invaluable in informing more beneficial, evidence-based policy decisions.
  • Public health reporting/tracking. Agencies will have access to unprecedented information for far keener insight into public health risks and trends, enabling better overall public health management.
These information advantages combine to enable the creation of the more efficient and sustainable health system we so badly need. ICD-10 is the underpinning to the future of value-based medicine. The movement toward value-based payment and quality initiatives-including meaningful use Stage 2, PCMHs, ACOs and more-depends heavily on the quality reporting and analytics made possible by the increased number of codes in ICD-10. At the same time, a successful transition to ICD-10 is key to providers' ability to thrive in this new era. We all need ICD-10.

That's why, delays aside, we'll have a transition to advanced code sets, and why health information professionals' best course of action is to keep moving forward full steam, with an eye on post-transition benefits. The degree to which those benefits are enjoyed at the time of transition will inevitably vary from provider to provider. Those who have realized the highest level of implementation success will be in far better position on all counts than those who lag behind.

More glass half-full: As health information professionals are increasingly concluding, the delay is an opportunity to more completely master ICD-10. After all, there's certainly no drawback to doing so ahead of schedule. Breathing room can mean the ability to turn off the translation tools that convert ICD-9 codes to ICD-10, removing the training wheels ahead of deadline to more fully prepare and perfect ICD-10 coding.

In that regard, the delay can be turned to advantage for all stakeholders, from providers to payers. By continuing with the steps they were (hopefully!) already taking toward a successful transition - now with more time to "get it right"-health information professionals can contribute significantly to their organizations' ability to realize positive financial outcomes in the long term, and to advancing the sustainable healthcare system we are all working toward.

Justin Barnes is a former vice president at Greenway Health, chairman emeritus of the Electronic Health Record Association (EHR Association) and co-chair of the Accountable Care Community of Practice (ACCoP).

Published URL ~ http://healthcare-executive-insight.advanceweb.com/Features/Articles/Staying-the-Course-on-ICD-10-Will-Bring-Immense-Benefit.aspx?zz=0#AnchorPostComment