May 21, 2013
That many healthcare providers have fallen way behind in their ICD-10 conversions is well-known (see my last post). But another ICD-10 timing issue is just as critical – the very obvious lack of synchronicity among stakeholders. When will healthcare providers, payers, and vendors start moving towards ICD-10 conversion as a united front?
In the end, on October 1, 2014, all three groups must be able to transact with each other, using ICD-10 codes.
There appears to be a growing gap in ICD-10 progress between providers and their IT vendor and payer partners. According to WEDI’s April 2013 ICD-10 Readiness Report, payers are well ahead of providers and vendors in their preparations. More than one-third of the 109 responding health plans have either finished or nearly finished internal business process design and development. Almost half of the payers expect to begin external testing by the end of 2013.
Vendors are on a different timeline. Only one-fifth of the 87 responding vendors said their ICD-10 products were ready, the same number as last year at this time. Two-thirds of the vendors plan to begin beta testing by the end of 2013. The remainder plan for beta testing in 2014.
Remember, of course, that half of the 778 responding providers said they didn’t know when they would complete just the first major step in converting from ICD-9 to ICD-10 — the impact assessment.
Overall indications are that most organizations are following their own timelines, with little interaction as yet with their trading partners.
If the transition from ICD-9 to ICD-10 is to be successful, it is clear that all three groups must begin to work together. They cannot sustain their silos. Fortunately, there are members of the industry that are beginning to address this issue.
Some states, including California, Massachusetts and Idaho, recently formed initiatives that may provide models for ICD-10 collaboration. For example, the new (February, 2013) California ICD-10 Collaborative has set a goal “for providers, insurers, vendors and associations to share best practices and collaborate in end-to-end testing, lowering risks and costs of implementing ICD-10.”
State collaboratives are beginning to receive external industry support. Notably, WEDI has just announced the creation of the WEDI ICD-10 State Collaborative Initiative, intended to bring state collaboratives together to “share best practices, collaborate in end-to-end testing, and work together to reduce the risk and effort required to implement the ICD-10 standard.” WEDI has been perhaps the most active and influential independent body focused on national healthcare IT transformation since the earliest days of HIPAA.
There is no way to know how effective ICD-10 collaboratives will be, but conceptually they hold promise. Hopefully, we will not have to look back and realize that these early signs of industry ICD-10 teamwork were too little, too late.