Navicure Survey Finds 'Shaky Optimism' toward ICD-10 Readiness

By Peter Bernstein
Senior Editor

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). This is a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. Here in the U.S., we have our own modified version ICD-10-CM (Clinical Modification) for diagnosis coding and Procedure Coding System ICD-10-PCS for inpatient hospital procedure coding which is set to go into effect October 1, 2015 following a two year delay.  It should go almost without saying how such coding impacts all aspects of healthcare billing.

With the above as context, Atlanta, GA-based Navicure, a provider of cloud-based healthcare billing and payment solutions, has announced key findings from its fourth ICD-10 readiness survey. There is good news and some cautionary news as well in the findings which  revealed that  healthcare organizations are overwhelmingly optimistic about being ready for the October 1, 2015, transition date.  The more problematic findings were that even at this late date only 43 percent of respondents feel they are currently on track with their preparation.

The survey, done by Navicure with the help of Porter Research in August 2015 is the fourth wave of a research study designed to trend attitudes and behavior regarding the transition to ICD-10.

“After conducting four ICD-10 readiness surveys over the past two years, Navicure is pleased to see progress in organizations’ preparations; however, we remain concerned. Too many organizations are still not equipped to successfully weather the transition”

A little additional background on the survey needs explanation. It should be noted that as with previous ones the composition of respondents was as follows: practice administrators or billing managers (58 percent), practice executives (14 percent), and billers and coders (14 percent). Navicure and Porter Research were careful that respondents represented a broad range of specialties and sizes, with the majority (67 percent) coming from physician practices with one to 10 providers.

Without further ado, here is what respondents had to say, which even with the clock ticking surprisingly varied widely in terms of the their views on the state of ICD-10 preparedness.

• Some 85 percent are still optimistic they will be ready when the transition happens
• Yet, 57 percent still do not believe they are “on track”

The findings focused on themes of timing, readiness and challenges. Again, it is an interesting mixed bag which includes:

• Impact on revenue and cash flow. Fifty-six percent of respondents noted cash flow was their greatest concern, while 94 percent anticipate an increase in their denial rate. While some organizations are being proactive in other areas to improve revenue and cash flow, such as improving patient collections (34 percent), denial management (30 percent) and patient price estimation (17 percent) processes, 35 percent have not adjusted their revenue cycle in preparation for ICD-10.
• Increased clinical documentation improvement. Thirty-one percent of respondents cite increased clinical documentation improvement and coding requirements as the most challenging aspect of the transition. Even with a well-trained staff, industry experts estimate staff productivity may decline by more than 50 percent. Navicure says it highlights the need to invest in training and/or resources that can help mitigate productivity loss due to coding errors.
• End-to-end testing results. Sixty percent of respondents who completed end-to-end testing reported the results were as expected and positive. However, more than 35 percent have not participated at all.

“After conducting four ICD-10 readiness surveys over the past two years, Navicure is pleased to see progress in organizations’ preparations; however, we remain concerned. Too many organizations are still not equipped to successfully weather the transition,” said Jim Denny, co-founder and CEO of Navicure. “Even at this late stage, it is still not too late for organizations to make meaningful improvements to their ‘3 P’s’ − people, products and processes − to be as prepared as possible. These surveys, along with our own client surveys, have provided our team with insight on how we can still best help healthcare organizations through the transition.”

Denny added, “Beyond Navicure’s^® Code Source (News - Alert)™ and Appeals products, our award-winning client service team will be a critical resource for our clients’ success. Additionally, Navicure offers a number of unique and complimentary ICD-10 resources to clients and non-clients alike including ICD10Hub.com and ICD-10 Analyzer™. We hope organizations take full advantage of all that Navicure has to offer.”

While the survey results are about compliance with changes in healthcare processes, there is a lesson here for any vertical market where government mandates and other compliance issues are paramount, i.e., unfortunately all vertical markets. Eventually deadlines do stick and non-compliance is not an option. Hence, waiting until the last minute, especially when it comes to making sure you have invested wisely in all three of the “P’s” is a path with risks of its own.