BELLEVUE, WA – Postponing ICD-10, whenever the new compliance date might end up being, would do little to improve readiness – but could have significant adverse effects and substantial costs, said a majority of respondents to a survey from Edifecs, which develops technologies for regulatory compliance and data exchange.
Less than 48 hours after HHS announced its intent to delay the Oct. 1, 2013 deadline this past February, Edifecs polled more than 50 healthcare professionals attending its 2012 ICD-10 Summit.
BELLEVUE, WA – Postponing ICD-10, whenever the new compliance date might end up being, would do little to improve readiness – but could have significant adverse effects and substantial costs, said a majority of respondents to a survey from Edifecs, which develops technologies for regulatory compliance and data exchange.
Less than 48 hours after HHS announced its intent to delay the Oct. 1, 2013 deadline this past February, Edifecs polled more than 50 healthcare professionals attending its 2012 ICD-10 Summit.
Among the findings: Nearly two-thirds of respondents (64 percent) believe a delay would not improve readiness, 76 percent believe a delay would harm other healthcare reform efforts, and 69 percent say a two-year delay would be either “potentially catastrophic” or “unrecoverable.”
“The message we heard loud and clear from conference attendees and survey respondents was to keep moving while the industry awaits the final decision on the extended deadline and which entities will be affected,” said Edifecs CEO Sunny Singh. “The survey results tell us that stopping or slowing down work is a very real outcome of a delay, and it could derail a healthcare organization’s progress. The cost implications alone are worrisome.”
With both payers and providers investing heavily for the ICD-10 switchover, cost was a chief concern. When asked about the impact of a one-year delay, nearly half of poll respondents said it would increase costs between 11 and 25 percent, and another 37 percent said their costs would be up to 50 percent. Edifecs estimates the cost of a one-year delay to be between 25 to 30 percent. Based on existing overall cost estimates for ICD-10 from multiple sources, officials estimate a year-long delay in ICD-10 could cost the industry anywhere from $475 million to more than $4 billion.
Other findings from the survey include:
• Nearly two-thirds of respondents (64 percent) said a delay would not result in improved readiness, predicting instead that organizations would slow down implementation so budget and personnel could be redeployed to other, more urgent initiatives. That's compared to 36 percent who said a delay would improve readiness; one potential benefit of a delay is more time for testing, but that assumes projects will not be slowed or stalled, officials noted.
• When asked what the preferred timeframe would be for a delayed compliance date, 85 percent of respondents said a shift in the compliance date should not exceed one year. A delay of longer than a year, they opined, would likely freeze budgets, slow down schedules or stop work altogether.
• More than half of respondents (59 percent) said the date should be moved out for all covered entities – as opposed to mandating different compliance dates for different types of entities. The main driver behind that overwhelming preference for a single compliance deadline appears to be the significant cost and effort needed for the dual processing in ICD-9 and ICD-10 code sets for the same dates of service, said Edifecs executives.
In March, Edifecs released a report outlining some other big takeaways from its ICD-10 summit. The consensus there, officials said, was that, despite the complexity of ICD-10 and its wide-ranging impact on healthcare enterprises, it's a worthwhile initiative that provides value to payers, providers and consumers.
The report found that achieving financial neutrality across the transition date is a key goal and significant concern of payers and providers. One challenge is how to define neutrality. Blue Cross Blue Shield of Michigan shared its six dimensions of neutrality and discussed how it plans to address each one. In addition, to achieve a successful ICD-10 transition, new levels of collaboration among partners would have to be reached, they said – citing the example of Cleveland Clinic and Medical Mutual of Ohio, who worked together to accelerate their timeline for ICD-10 implementation – potentially saving Cleveland Clinic $7 million.
Healthcare organizations need to take a risk-based approach to internal and external testing, Edifecs officials argued, due to the magnitude of testing that would be required for every business process, technology solution and claim scenario. They pointed to Humana, which is analyzing historical claims to identify high-risk scenarios. By focusing testing scenarios on those that could have the most impact, Humana was able to reduce ICD-10 testing scenarios from several hundred thousand to just a couple of hundred.
Finally, if HHS does delay the compliance deadline for ICD-10, it will do so in the face of strong opposition from payers and providers that have taken the lead in the industry and are already well on the path to meeting the original deadline.
"Successful ICD-10 implementation will rely heavily on cross-departmental collaboration, disciplined project management and organizational readiness," said Singh.
