al aha i 10 loe presentation 11 8 13
DESCRIPTION
ICD-10 Readiness - Minimizing the Loss of Effectiveness as You Prepare for ChangeTRANSCRIPT
Page 1November 8, 2013
Prepared for Alabama Hospital Association
Page 2November 8, 2013
Prepared for Alabama Hospital Association
Alabama Hospital Association
November 8, 2013
ICD-10 Readiness
Minimizing the Loss of Effectiveness as You Prepare for Change
Page 3November 8, 2013
Prepared for Alabama Hospital Association
Identify the organizational impact of ICD-10 preparation and implementation
Develop a communication sponsorship tree
Illustrate the Loss of Effectiveness (LOE) Index® change readiness tool
Learn preliminary steps of developing a change management work plan
Learning Objectives
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Why Change Fails
Organizational change initiatives continue to experience a failure
rate approaching 70%.
Sources: Standish 2009, IBM 2008, Raps 2004, Beer 2003, Miller 2002, HBR 2000, Senge 1999, Strebel 1996, Kotter 1995
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How Big Could It Be?
ICD-9-CM
Diagnosis: 14,025
Procedures: 3,824
ICD-10-CM & ICD-10-PCS
Diagnosis: 68,069
Procedures: 72,589
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AR Days 20% – 40%
Denial Rates 100% – 200%
How Big Could It Be?
Source: Britt, John & Deb McReavy. (October 1, 2013) “Preparing for ICD-10’s Impact on Your Revenue Cycle”. ASC Communications 2012. Retrieved from http://www.beckershospitalreview.com/white-papers/preparing-for-icd-10-s-impact-on-your-revenue-cycle.html
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ICD-10 Organizational Impact
• Physician Documentation• Physician Integration• Physician Performance
• Staffing Effectiveness• Revenue Impact Assessment• Process Flow & Improvement• Decision Support Impact
• Documentation Analysis• ICD-10 Education & Training• Coding Production Impact
Physician Office
Post Acute Services
• Scheduling, ED & Access Areas• DNFB, Coding, CDI• Case Management • Billing, Reimbursement
Health Information
Management
ICD-10
Revenue Process
PhysicianOperational Planning
Information Technology
• IT Systems• Capability, Communication• Functionality• Vendor Preparedness
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Communication
Engage public relations team
Develop communication plan
• Hospital/physician community
• Educate patients about potential claim denial or delayed claim processing due to new codes
• Ongoing status of organization’s ICD-10 migration
Communicate early and often
• Talking points should be clear & concise
• ICD-10 – what it is and what it isn’t
• Focus on the positive - minimize fear
• Consider social media, blogs, “tweets”
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Change Management:Key ICD-10 Project Stakeholders
Scheduling / Patient Access
AreasHealth Information
Management
Information Technology
Decision SupportPhysician Advocate
Billing & Reimbursement
Human Resources
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Change Management StrategyConvene Implementation Taskforce
Multi-disciplinary• Clinical, IT, HIM,
Finance, Compliance, Communications, Payer/Managed Care Contracting, Operations
Key stake holders • Identify who is
impacted and what needs to be done
• Establish timeline and designate leaders
Designate physician champion
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Initiating Sponsors
Change Management: ICD-10 Sponsorship Tree
• Strategically legitimizes the implementation of change• Ensures strategic alignment, support, and inclusion• Executive leader endorsing and communicating organization-wide
change initiatives
• Sanctions the change in relevant area of responsibility • Coordinates activity and defines consequences• Department and service line leaders
• Orchestrates activities and tactical plans within their local area (front line management)
Sustaining Sponsors
Change Recipients
Local Sponsors
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Chief Financial Officer
ICD-10 Team Resources Sample Sponsorship Tree and Structure
PFS Manager
Director of Revenue Management
Chief Information Officer
Physician Champion
Director of Coding
Director of Health Information ManagementLead Sustaining Sponsor
Sustaining Sponsors
Training & Development
Manager
Marketing/ Community
Relations Manager
Coding Manager IT Analyst
Local Sponsors
Initiating Sponsors
Director of Patient Financial Services
Chief Compliance Officer
Practice Administrator
Patient Access/ Admissions
Manager
Decision Support Analyst
Revenue Cycle Manager
Marketing/Community Relations Director
Clinic Manager
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Organizational Change
Organizational change causes a loss of stability, which results in the development of a
predictable and measurable set of symptoms within an organization.
When a significant number of these symptoms are present, an organizational loss of
effectiveness will occur.Source: Grady, 2005
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Loss of Effectiveness®
Identify the riskMeasure the
risk of change to the individual
Address/resolve the risk prior to
change
The LOE Index® determines the risk of change to the person, which ultimately impacts the success of change in the
organization.
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Loss of Effectiveness (LOE) Index® Change Readiness Assessment
• People determine the success of any change
• Loss of Effectiveness (LOE) Index® measures six defined symptoms that determine the risk of change to the person, which ultimately impacts the success of change in the organization
Individual Symptom Organizational Symptom
Anxiety Decreased Morale
Frustration Loss of Productivity
Rejection of the Environment Increased Conflict
Retardation of Development Decreased Motivation
Refusal to Participate Increased Absenteeism
Withdrawal Increased Turnover
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LOE Index® Results by Department
A D F G P R W AVG.1.00
1.20
1.40
1.60
1.80
2.00
2.20
2.40
2.60
Coding Information Systems Medical Records Patient Access Services
Patient Financial Services Transcription Utilization Review
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LOE Index® Results by Leadership
A D F G P R W AVG.1.00
1.20
1.40
1.60
1.80
2.00
2.20
2.40
2.60
Director Or Manager Front Line Employee Supervisor Or Team Lead
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LOE Index® Results by Years of Service
A D F G P R W AVG.1.00
1.20
1.40
1.60
1.80
2.00
2.20
2.40
2.60
0 To 5 Years 6 To 10 Years 11 To 20 Years 20 Years
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LOE Index® Qualitative Responses: Examples
Communication“It would be helpful to have a "heads-up" prior to implementing changes. At times, changes are
made and put into place and then those who are supposed to follow through with these changes
are informed.”~
“Sometimes having more of a heads up to upcoming changes would be great. We have
expressed this to our leadership before and they have made vast improvements to do so.”
Training“I believe there should be MANDATORY
training classes for those that the changes are going to effect. This would result in less confusion when changes
are implemented.”~
“Training immediately prior to, during and after implementation.”
~“More training in all departments to make
the workflow more efficient. A better understanding of why things are done a
certain way.”End User Involvement“The most important thing to me is to include the
persons that the change will most affect in the process. Take their concerns into consideration before a final decision is made and the change
is implemented.”
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Change Management Work Stream Infrastructure
• Impact Identification• Knowledge Leveling• Data Gathering
Awareness & Assessment
• Sponsor Tree Definition
• Identification of Sponsors
• Communication Plan
Sponsorship • LOE Index • Analysis of Results• Action Identification
Effectiveness Assessment
• Converge Impact & Effectiveness
• Training• Communication /
Sponsorship
Path Forward
Change Management Work Stream Focus: Communication plan detailed for specific audience knowledge levels Sponsorship tree definition and identification of individuals Effectiveness index summary results and action identification
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The Bottom Line: What you need know
Current state of employee readiness (LOE Index)
Does my ICD-10 communication plan clearly address internal and external inquiries
Current vendor readiness & testing environments
Physician documentation – Know your risk
AR Days, Denials, and CASH
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Questions?
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Contact Information
Kristen Lilly, MHA, RHIA, CPHQ
Consulting Manager
Pershing Yoakley & Associates, P.C.
(800) 270-9629
www.pyapc.com