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TRANSCRIPT
Hospital Industry ICD-10 Preparedness
Survey Results: Status of Hospital Progress in the Transition to ICD-10
December 12, 2013
By D’Arcy Guerin Gue Phoenix Health Systems
Survey Report
CMS (Centers for Medicare and Medicaid) has repeatedly confirmed that the healthcare industry must transition its documentation and transactions from ICD-9 to ICD-10 coding by October 1, 2014. As of that date, no claims using ICD-9 codes will be paid for dates of service occurring on or after October 1st, 2014.!!This survey indicates that progress towards this transition remains slow in many U.S. hospitals. However, it reflects bright spots in achievement. The survey also provides!insight into the varied status of ICD-10 implementation, and the hurdles being faced, by hospitals based on their size.!!Here we highlight some of the key findings from our fall 2013 survey.!!Phoenix Health Systems thanks the many individuals and hospitals that supported this survey initiative.!!!
From mid-September into November, Phoenix Health Systems conducted a short online ICD-10 Preparedness Survey of hospitals across the country, intending to make our results public upon receiving at least 100 participants. Our 101 responses represent a broad cross-section of the hospital industry, plus 11 non-hospital providers. This report focuses on the responses of the hospital participants. !!!!!!!!!Respondents included members of the C-Suite, HIM Directors and other Managers, includingICD-10 Project Managers. !!!In line with trends observed throughout 2013, our results show that, in general, the larger the hospitals, the more progress they have made towards the conversion from ICD-9 coding to ICD-10. !!
Survey Responses
Phoenix Health Systems ICD-‐10 Survey Results
Most large hospital systems – ranging from 600 to 2000+ beds -- have little doubt that they will be ready to transition to ICD-10 by the compliance deadline of October 1, 2014. !!!!!!!!!!!!!!!!They are well beyond the assessment and planning stages, and 46% of them are well into their implementation. 38% have just begun their implementation projects. !!Most are coordinating timelines with their vendors and payers. !
Large Hospital Systems Status
Phoenix Health Systems ICD-‐10 Survey Results
Still, after reporting such strong efforts, only 1/3 of these respondents consider their work to be 50 – 75% complete, another 1/4 feels they are 35 – 50% done, and 30% say they have achieved 20 - 35% of the work required. !!!!!!!!!!!!!!!Will they be ready to conduct ICD-10 transactions by the deadline? !75% of large hospital systems say “yes.”!!!!!!!!!!!!!!!!!
Large Hospital Systems Status
Phoenix Health Systems ICD-‐10 Survey Results
33%!
25%!
30%!
While not as far along as large hospital systems, 58% of hospitals with 400 - 600 beds have initiated their implementation project. Only 17% are well into their implementation projects. The remainder have made little progress.!!!!!!!!!!!!!!!Similar to the larger hospital systems, large hospitals are working actively with their vendors and payers. !!!!!!!!!!!!!!!!
Large Hospitals’ Status
Phoenix Health Systems ICD-‐10 Survey Results
One third of this group stated they are 10% – 20% finished with the total implementation work required. The remaining 2/3 of the group range along a continuum from 20% – 90% complete, with about 15% of respondents reporting within each category of progress. !!!!!!!!!!!!!!!Just 42% predict they will be able to conduct ICD-10 transactions by the compliance deadline, though another third feels it is “somewhat likely.”!!!!!!!!!!!!!!!!
Large Hospitals’ Status
Phoenix Health Systems ICD-‐10 Survey Results
Overall, smaller hospital organizations appear to have made little progress towards meeting the ICD-10 deadline. !!36% of respondents from hospitals under 400 beds (including hospitals under 100 beds) have not begun conducting an organizational impact assessment -- the first major stage in the remediation process.!!26% have at least conducted the pre-work of providing general knowledge awareness sessions with senior management, but nearly 10% have not yet taken any steps to begin their move to ICD-10.!!A breakout analysis of smaller hospitals’ progress follows, covering hospitals from 100 – 400 beds, and hospitals under 100 beds.!!!!!!!!!!!!!!!!
Smaller Hospitals’ Status
Phoenix Health Systems ICD-‐10 Survey Results
46% of one sub-group – hospitals with 100 - 400 beds – have completed assessments, created project plans, and are working on implementation. About 2/3 are working with their vendors, but less than half with payers.!!!!!!!!!!!!!!!!!37% believe they have finished 20 – 35% of the overall work required, and 30% feel they are 35 – 50% complete. But 21% of this sub-group believes they’ve done no more than 10 – 20% of the work needed to achieve ICD-10 conversion by October 1, 2014. !!Still, most respondents in hospitals with 100 – 400 beds are optimistic. 63% predict they will achieve their ICD-10 transitions on time.!!!!!!!!!!!!!!!!!!!!!!!!!!!
Smaller Hospitals’ Status
Phoenix Health Systems ICD-‐10 Survey Results
30%!
37%!
21%!
The country’s smallest hospitals are faring worst. 50% of reporting hospitals, with under 100 beds have not initiated an impact assessment. Most of these hospitals have not yet established a sponsor or steering committee. 30% have completed project plans and are working on implementation. Less than half have contacted vendors and payers. Overall, 63% stated they have completed less than 20% of the work required to convert to ICD-10. !!!!!!!!!!!!!Will these hospitals be able to transact business using ICD-10 codes by October 1, 2014? Respondents are generally optimistic, despite limited progress. 43% said they are “very likely” to meet the deadline; another 43% believe they are “somewhat likely” to do so.!!!!!!!!!!!!!!!!!!!!!!!!!!
Smallest Hospitals’ Status
Phoenix Health Systems ICD-‐10 Survey Results
We asked participants about the key challenges they are facing in their ICD-10 efforts. Regardless of organizations’ sizes or progress, all agreed that “dealing with competing initiatives” was their most significant hurdle. !!!!!!!!!!!!!Other major challenges noted were, in order: major business impact, major IT impact, and lack of staffing. !!Not surprisingly, smaller hospitals under 400 beds reported that insufficient staffing and expertise are pre-eminent concerns. Hospitals under 100 beds also emphasized issues of inadequate knowledge, and lack of funding, and physician engagement. !!!!!!!!!!!!!!!!!!!!!!!!!!
Key Challenges
Phoenix Health Systems ICD-‐10 Survey Results
Respondent Commentary We requested comments and we got them! !
A representative sampling…!
“Very costly for a small facility”…!”No budget to implement until 2014.”!
“Also in major implementation for MU.”!
“No knowledge or expertise in this area.”!
Home-grown billing system a problem;” !“Legacy billing system hurts.”!
“The greater challenges are engaging the providers that will be documenting to support ICD-10 diagnosis…one of the largest hurdles
in making a successful transition…” !“Physicans not on board.”!
“There is a lack of coders in general !and learning a new coding system is very complex.”!
“There doesn’t seem to be a sense of urgency yet, although am hoping after the 1st of the year this will kick in.”!
“Too soon to tell – exec team has not bought in.”!
“Some on staff think the Oct 1, 2014 date will be !pushed out into the future.”!
Phoenix Health Systems ICD-‐10 Survey Results
Takeaways There’s no doubt - ICD-10 is huge. The ICD-10 transition is one of the largest, most complex organizational projects many hospitals have ever faced. The results of this survey confirm what many of us in the industry already knew…!
!Progress is slow.!
!Even though the largest providers have made the most progress, over half believe that they are less than halfway to compliance, and almost 40% have just started their implementation. In the under 400 bed group, a large majority (63%) believe they have completed less than 20% of the work required. Of the smallest hospitals, half have not completed their initial assessments, let alone planning their implementation projects and getting them started.!!Lack of expertise and staffing were cited by hospitals of all sizes as key obstacles to a successful transition, and many hospitals explicitly named Meaningful Use efforts as a major competitor for time and resources. !!With about nine months left to meet the ICD-10 deadline, and even less time before many hospitals must begin their measurement periods for Meaningful Use, the challenges to IT staff, physicians, and other stakeholders in both projects will only increase.! !!
Phoenix Health Systems ICD-‐10 Survey Results
Takeaways�
As we enter 2014, it is readily apparent that many hospitals will need to address issues of insufficient expertise and resources. They should consider reaching out to their software vendors, or to experienced consultants to augment their teams. This will be especially important for smaller hospitals who are not only short-staffed, but often do not have the knowledge and expertise needed to implement ICD-10. !
All providers should take heed. !!Regardless of size – and regardless of their current state of readiness, we recommend that hospitals: !• Take a fresh look at their ICD-10 project in the new year.!• Prioritize the items that will have the largest overall impact to
the project, and, potentially the revenue cycle.!• Take aggressive steps to manage the greatest risks.!
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Phoenix Health Systems ICD-‐10 Survey Results
This survey was conducted online through SurveyMonkey, an independent service, from mid-‐September through November 30, 2013. Hospitals were invited to parJcipate through a broad email campaign, LinkedIn, and Phoenix Health Systems’ web site.
Have you begun your move to ICD-10?�
Does your organization have the staff and expertise to meet the October 1, 2014 deadline?
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Phoenix can help. �
If your leadership team wants to better understand the challenges ahead, we will tailor a one-hour educational
webinar for them, to answer their questions.
Phoenix provides end-to-end ICD-10 implementation services or “fill-in” expertise where you may need specialized help. We
have worked for over 20 years with hospitals of all sizes, and have developed a specialty practice of scaled ICD-10
services for small to medium-sized hospitals.
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Contact Us Contact us: Phoenix Health Systems [email protected] 214.261.0660
You may also contact D’Arcy Guerin Gue, the author of this report and co-founder of Phoenix Health Systems, at: [email protected]