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25% of Physicians Won’t Be Ready for ICD-10 Implementation

- There are only fifty-eight days until the ICD-10 deadline, yet only one in five physicians has even started conducting external testing with health plans or clearinghouses, WEDI says in a press release detailing results from its latest ICD-10 readiness survey, and less than half of physician practices believe they will be ready to make the big switch by the implementation date. 

ICD-10 implementation

Nearly 25 percent stated that they are sure they will not be ready to meet ICD-10 implementation requirements, while a similar number reported that they have no idea what will happen when October 1, 2015 rolls around.

While hospitals and payers are somewhat further along in their preparations, one in ten health systems isn’t sure if they will be ready for the implementation date, and a quarter of health IT vendors still have some work to do before their ICD-10 compliant products are fully developed.

“While much of the industry is nearing readiness, nearly one-quarter of physician practice respondents said they will not be ready by the October 1, 2015 deadline and another one-quarter were unsure,” said Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair. “Without a dedicated and aggressive effort to complete implementation activities in the time remaining, this lack of readiness may lead to disruption in claims processing."

Physician practices, especially smaller ones, have always been concerned about their ability to meet the technical and administrative challenges of the ICD-10 transition, and have always lagged behind their larger peers in preparation status.  Whether they simply have no resources to spare for the transition or have been banking on a new series of delays, physician reluctance to embrace ICD-10 implementation remains a major source of concern for CMS and other stakeholders.

CMS and the American Medical Association (AMA) recently announced flexibility provisions that are intended to make the switch a little easier on providers, but without a major last-minute push to help healthcare organizations complete the necessary steps for a successful ICD-10 transition, providers may be in line for significant delays to payments, claims denials, and other revenue cycle disruptions.

Other results from the survey of more than 620 industry stakeholders are somewhat more positive, and include the following:

• Three-fifths of EHR and health IT vendors stated that they had completed ICD-10 compliant product development.  One fifth were at least 75 percent of the way through development.  All vendors believe that their products will be available before the October 1, 2015 compliance date.

• Two-thirds of health plans have completed their impact assessments, and one-fifth reported being nearly finished with their foundational planning.  While these numbers indicate a downward trend in preparedness compared to the February 2015 survey, WEDI attributes this to responses from a different pool of health plans.

• Physician providers and hospitals indicate lower levels of impact assessment planning.  Less than one in every six physician practices have a completed ICD-10 impact assessment.  Three-fifths of hospitals reported having a finished assessment in hand.

• Payers are much further along than providers when it comes to ICD-10 external testing.  Nearly 75 percent of health plans have made at least some progress towards completing their external testing plans, up from just 50 percent in February.

• Nearly 40 percent of payers indicated that they are fully prepared for ICD-10 implementation, and the remaining 60 percent are confident that they will be ready by the deadline.  Seven eighths of hospitals or health systems are already prepared or think they will definitely be prepared by October.

• Two-thirds of hospitals and health systems are planning to conduct external testing with their business partners, compared to just a sixth of physician practices.  Two-fifths of physicians are only planning to test with their clearinghouses.

“Uncertainty over further delays was listed as a top obstacle across all industry segments,” Daley wrote. “While the delays provided more time for the ICD-10 transition, it seems that many organizations did not take full advantage of this additional time.”

“It should also be noted that this survey was released prior to the CMS-AMA announcement describing how these two organizations are joining together to provide support for physicians,” the survey points out. “Physician practices may now be working more quickly toward compliance, since the potential for further delay has been removed.”

WEDI believes that CMS must continue to reach out to providers and make ICD-10 transitional resources available to the large number of healthcare organizations still lagging behind during the last few months of the preparation period.

“It is critical to closely monitor industry progress and testing as we approach the compliance date to gauge what might occur on Oct. 1, 2015,” added Jean P. Narcisi, chair of WEDI. “In light of our most recent findings, we are hopeful that industry leaders take the necessary steps to help ensure that the transition to ICD-10 is completed with minimal disruption to the healthcare industry.”

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