Specialist recruitment agency, Greythorn, partners with ICD-10 specialist, Kathleen McHugh in light of the major conversion in United States’ health systems. The upgrade from ICD-9 to ICD-10 will challenge hospitals and health systems in the short run, but improve insurance abilities and increase knowledge of outcome-based diagnosis. However, since the deadline was pushed back a full year, some health systems have pulled back their efforts in hopes of stalling a bit further. McHugh and Director of Healthcare IT at Greythorn, Mary Beth Seaman, weigh in on the implications of these decisions and more.
ICD-10 is something hospitals can choose to embrace or ignore, but if they embrace it, there are a lot of synergies they can accomplish with other initiatives.
Be strategic about the process. The more robust your strategy, the more likely you are to succeed in this implementation.
Greythorn can contribute greatly to finding qualified people for the necessary positions. There are some large hospitals that will not need project managers, but will need trainers and coders. Some hospitals will need everything and we are prepared to provide a pipeline of candidates who will successfully contribute to the implementation process on a full time and contract basis.
In 2013, contract agreements are likely to be around 12 months because hospitals will want to retain their resources as close to the time of conversion as possible in order to facilitate a smooth transition period.
Overview of positions in demand
- Project Managers – Many facilities are taking their time to evaluate the current state and determine their needs. Once they decide to move forward in full-force, having skilled Project Managers aware of the impact and multiple systems will benefit the implementation greatly. There are currently a high number of PM roles open nationwide.
- Coding/Quality Managers – Coding is tied to quality outcomes, which directly impacts the ease of implementation. Health systems are concerned about revenue implications after implementation, as the initial loss of revenue is likely following the implementation. Senior level professionals in this field are in high demand.
- Trainers – Due to a decrease in productivity from individual coders at the initial implementation of ICD-10, trainers will be critical in assisting existing professionals up to speed with the new system in order to return to business as usual.
Advice to job seekers in the HIT space or medical billing
If you have ICD-9 experience, there are AHIMA programs online to train for ICD-10 that will help prepare for the implementation. The HIMSS ICD-10 playbook is a fantastic resource. Stay up to date with the tools out there and keep up with the industry.
There are significant openings throughout the spectrum of ICD-10. Dozens of roles open on a daily basis and many large turnkey solution organizations have dedicated entire departments to ensure a successful implementation.
Given the shortage of candidates currently, an increase of needs and a deadline approaching quickly, salaries will become more competitive over the next couple of years. The demand for qualified professionals will be immense and it is advised that current experts seek training in order to take advantage of this demand in the next 12 to 18 months.
Advice to hospitals that pulled out of implementation stages when the deadline changed
Get started today – although the deadline may have changed, the implementation is inevitable. The sooner organizations begin to adopt these codes, the better chance at a smooth and successful implementation they have.
The people who have true focus on this are already implementing this program. There are qualified candidates out there today ready to be hired and integrated into the health systems - especially coding and billing professionals who are familiar with general procedures. Resisting implementation is going to negatively affect talent management. How are organizations going to retain their top talent otherwise?
What are the pros and cons of health systems beginning to implement ICD-10 now?
As of now, the conversion deadline is October 1, 2014. Although it is likely that most healthcare entities and hospitals will successfully achieve implementation by this date, it may be by the “skin of their teeth” – as it is a huge step up from the current set of codes we are using. If these organizations start digging their heels in today, they will spend all of the time between now and 2014 working on this implementation. It will take a tremendous amount of effort to achieve, but they will be able to get it done.
Documentation on the physician side is going to be cumbersome so that coders can reflect the true condition of the patient. Recording will be tedious and some requirements will make it easier, but if hospitals do not change their documentation, they will end up having to do twice the amount of work per patient.
The United States is one of the last adopters of ICD-10. Why not wait for ICD-11?
The implementation of ICD-10 is crucial because ICD-11 will reorganize all of the codes. The conversion from 9 to 10 is a matter of expanding the number of codes available. From what we have today, ICD-10 will increase the number of codes by X,000,000 and version 11 will organize them to accurately reflect what is a chronic or acute condition. 10 cannot handle the specifics.
Will the transition be smoother between ICD-10 and ICD-11?
The transition seems to be smoother for ICD-10 to 11, but as the US is one of the last to adopt, other countries will go to 11 first. One of the biggest setbacks in upgrading has been that the United States has such a complex payer system. The healthcare system structure is much more complex than others around the world, so we can look at other countries and their implementations, but it is just a piece of the puzzle in the long run.
What is the biggest challenge for hospitals in this implementation?
The first challenge is that they have to complete an overall assessment on the entire organization about where all of the ICD-9 codes are today. Healthcare organizations will have to think about the changes and assess all of the systems that use the 9 codes to make sure they can host new codes. If this assessment is not completed, the conversion will be an absolute nightmare. Similar to any project, there is a tremendous amount of work and effort in the beginning and the end. Hospitals will have to train their staff to use this new system. How can we do this effectively for 500,000 physicians? Will this be standardized or left to hospitals on their own? These are a few things left to be determined.
What does this mean for patients?
If the conversion is not done correctly, patients will see a lot of bills that they should not see. For example, if the wrong code is applied, the bill will get sent to the patient. Alternatively, when patients need medical records, hopefully they will have better historical records and be able to track and manage their medical history.
No doubt, the way diseases are managed will change, not necessarily the available care for them. Insurance companies will pay out on positive outcomes.
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