MGMA ICD-10 survey cites physicians greatest ICD-10 transition concern is the lack of communication and critical coordination between physicians practices and their business transaction partners.
Almost 50 percent of physician groups have not heard from their EHR vendors regarding the date when their software would be ICD-10 compliant according to recent research by Medical Group Management Association (MGMA). The research findings based on responses to a survey of 1,200 medical groups representing 55,000 practicing physicians highlights mounting concerns on the overall industry’s lack of ICD-10 preparation and readiness.
The findings report the greatest concern is the lack of communication and critical coordination between physician practices and their essential trading partners (such as claims clearinghouses, electronic health record (EHR) vendors and practice management system vendors) regarding software updates and testing, which has not yet occurred.
“It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades. Adding to the implementation challenge and clearly taxing all stakeholders, ICD-10 will arrive at the same time that a number of other transformative federal policies go into effect, such as health insurance exchanges and Stage 2 of the CMS Meaningful Use EHR Incentive Program,” said Susan L. Turney, M.D., MGMA’s president and CEO.
More than 52 percent of respondents indicated they had not heard from their practice management system vendor regarding when software changes would be available to the practice. Vendors who fail to release their implementation and testing schedules risk jeopardizing the healthcare organization’s ability to successfully meet the ICD-10 compliance date. This lack of support has a significant impact on other important action items critical to the ICD-10 transition.
Potential areas of risk from late EHR ICD-10 compliance include:
- Lack of appropriate dual coding testing
- HIM/Coding staff ability to dual coding for training/education purposes to prepare for productivity impact
- Validating EMR readiness to support the clinical documentation impact of ICD-10
Other research findings include:
• Internal software testing lags- Only 5.9 percent of respondents reported that internal software testing has begun or is complete with their practice management software vendor and 4.7 percent with their EHR vendor.
• External testing delays- Just 11.9 percent of respondents reported that external testing with their clearinghouse has started or is complete. Almost 60 percent reported that they have not even heard from their clearinghouse regarding a testing date. Only 8.6 percent have started or have completed testing with their major health plans, with a concerning 70 percent stating that they have not heard from their major health plans.
• Low confidence for a successful transition- Nearly 60 percent of respondents stated they are “slightly” or “not at all confident” that their major health plans will be ready to meet the Oct.1, 2014, compliance date.
• Concern about changes to clinical documentation- Among a number of implementation concerns, 88 percent are concerned or very concerned about the expected changes to clinical documentation; 87.5 percent are concerned or very concerned about the loss of clinician productivity after implementation; and 81.1 percent of respondents indicated they are concerned or very concerned with the overall cost of switching to ICD-10.
• Absorbing costs for transition- Only 32.5 percent of respondents report that their cost to upgrade or replace their practice management system software will be covered by their vendor. Only 37 percent say their vendor will cover the cost to upgrade/replace their EHR.
• Cost of transition- For those organizations that must cover the costs themselves, the average cost for a 10-physician practice to upgrade or replace their practice management system and EHR software to accommodate ICD-10 is $201,690.
Should EHR vendors, health plan, and clearinghouses guarantee ICD-10 compliance to healthcare organizations? Let us know your thoughts.