Electronic Health Records

Adoption & Implementation News

Physician practices very concerned about ICD-10, says MGMA

By Kyle Murphy, PhD

Concerns are high among physician practices working to implement all the changes required to comply with ICD-10 come October 1, according to a Medical Group Management Association survey conducted last month.

“The critical coordination that must take place between practices and their software vendor, clearinghouse and health plan partners is simply not happening at the pace required for a seamless implementation. Very simply, ICD-10 is behind schedule,” MGMA President and CEO Susan L. Turney, MD, MS, FACP, FACMPE, said in a public statement.

The Legislative and Executive Advocacy Response Network (LEARN) survey of more than 570 physician group practices comprising more than 21,416 physicians show high levels of ICD-10 levels of concern in several areas. The response of “very concerned” led in five of six areas:

• Changes to clinical documentation (67.6%)

• Loss of productivity of coding staff after implementation (65%)

• Loss of clinician productivity after implementation (64.8%)

• Overall cost of converting to ICD-10 (47.3%)

• Cost of upgrading or replacing practice software (35%)

The only exception to the rule was concerning having executive management support for the conversion, which was “of little concern” to 27.4 percent of respondents.

Respondents also reported increased difficulties completing four out of six practice activities as a result of the conversion to ICD-10. The ability of clinician to select appropriate diagnosis code (67.3%), ability to include most frequently used diagnosis codes on a superb (60.3%), and ability of coding staff to select appropriate diagnosis codes (51%) were deemed “much more difficult.”

Likewise, the ability to document the patient encounter (48.7%) and ability to compare new diagnosis data in ICD-10 with previously collected diagnosis data using ICD-9 (45.3%) were considered “somewhat more difficult.” However, respondents did not believe that the ability to outsource billing (56.7%) and ability to contract with health plans (52.7%) would change.

Workflow is not the only thing that must change to accommodate the new code set. A vast majority of those surveyed indicated the need to upgrade both their practice management (PM) and EHR systems, 78.2 and 78.1 percent, respectively. According to respondents, roughly have will the cost of upgrading or replacing their EHR systems covered by vendors whereas they were mostly divided on whether the practice or the vendor would cover the cost of upgrading or replacing the PM system.

What’s more, the greatest number of physician practices (36.2% for PM, 33.1% for EHR) does not expect to make their appropriate technology switches until April 1. This would explain why the number of respondents to begin testing their PM software between June 1 and October 1 (31.7%) is higher than any other category. (For the record, only two percent have completed the testing and 9.9 percent have even begun it.) For EHR, the greatest number simply do not know (36.2%).

MGMA has reiterated the need for the Centers for Medicare & Medicaid Services (CMS) to increase its efforts to ensure that providers are able to properly test their ICD-10 coding practices.

“As the agency overseeing the nation’s largest health plan, it is imperative that CMS show leadership by reversing its position and begin end-to-end provider testing,” added Turney. “The publication of testing schedules, payment policies and readiness levels are all necessary actions for both CMS and practice trading partners in the private sector. Without this preparation, there will be significant increases in cash flow disruptions to practices that will affect the ability to treat patients.

Read the full results here.

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