Why 2010 is the pivotal year for ICD-10

Carl Natale
by Carl Natale

The time has come to decide whether to pursue ICD-10 as a strategic initiative or backburner the conversion until it ultimately drains resources, financial and otherwise, just to meet the federal mandate.

HHS has been clear that it won't push the October 1, 2013 deadline back again. Yet, as of now, there is still a surprisingly large number of organizations not taking initial steps.

“On sheer numbers, people are behind the recommended timeline,” says Mark Williams, PWC's lead partner on ICD-10. “The big payers are starting. Providers seem to be doing very little. Some IT vendors are moving forward, others not yet.”

HIMSS most recent research backs that assertion. A survey published by the organization, in fact, determined that only 9 percent of respondents have actually initiated an ICD-10/HIPAA 5010 project. What's more, providers are not sure what they'll have to do to become compliant, HIMMS states in the December report Provider Survey on 5010/ICD-10 Progress.

Many hospitals, for instance, are already facing resource-consuming agendas such as healthcare reform, and EMRs, so they're averse to the risk of being an ICD-10 first mover, says Eric Brown, vice president and research director at Forrester Research. That risk being that the conversion goes poorly and they wind up as a test case – of what not to do.

7 benefits of ICD-10

The new standard promises several critical benefits – if providers chart a proper course. Yet, a somewhat-alarming percentage of healthcare professionals don't yet fully comprehend ICD-10's benefits.

Only 41 percent of health plans believe that the conversion presents opportunities, according to a report by Milliman published in mid-January. “Most of the remaining respondents simply do not know what change ICD-10 will bring for their organization,” the report states.

Something healthcare IT pros should know: By moving now, rather than waiting, healthcare organizations have an opportunity to achieve business value and perhaps even competitive advantage via ICD-10. Wait too long, though, and that big chance might just pass.

Milliman's report, ICD-10 readiness, lists 7 key benefits ICD-10 will bring: more accurate payments for new procedures, fewer rejected claims, fewer improper claims, better understanding of new procedures, improved disease management, better understanding of health conditions and healthcare outcomes, and harmonization of disease monitoring and reporting worldwide.

Risks of Standing Still: Missed Opportunities and More

To tap into those advantages on Milliman's list, organizations need to do a certain amount of work now, or the October 1, 2013 deadline will come up quickly, explains Janice Young, program director at IDC's Health Insights practice. In addition to potentially missing out on business value or competitive advantages, delaying the ICD-10 conversion until the eleventh hour could also sidetrack other IT projects.

“You don't want to wait and wait and wait until the last minute and then have to attack it like a fire drill,” Forrester's Brown adds. “That will only cost more money for lesser results.”

Analysts were clear that smaller organizations are not facing the same sense of urgency just yet but, regardless of a provider's size, since ICD-10 is a requirement, the earlier you start, the sooner you'll be able to take advantage of any benefits.

At the very least, Brown adds, it's a good idea to asses your particular situation so healthcare organizations will understand what steps are necessary to reach ICD-10, how to get there, and how long it will likely take.

“ICD-10 can be strategic, and you can find competitive advantage,” PWC's William says. “But if you're not starting in 2010, the opportunity window could close."