Tony has a strong expertise in the healthcare and managed care/payer arena. He currently manages the workflow of Oncology Business Management, a business trade journal geared towards community oncologists/hematologists.

Physician Providers Still Lagging in ICD-10 Readiness

Published: Friday, Sep 26, 2014

Although the ICD-10 launch was moved to October 1, 2015, vendors and health plans look to be making some progress on the switchover. The same can't be said for physician providers, however. In a letter to Sylvia Mathews Burwell, Secretary of the Department of Health and Human Services, Jim Daley of the Workgroup for Electronic Data Interchange (WEDI) said that the results of its survey showed that two-thirds of provider respondents have slowed down efforts to upgrade or placed efforts on hold. Daley wrote that, "While the delay provides more time for the transition to ICD-10, many organizations are not taking full advantage of this additional time."

WEDI has been conducting readiness surveys since 2009 to gauge the status of industry and provider progress. This latest survey was completed in August 2014 and involved 514 respondents consisting of 324 providers, 87 vendors and 103 health plans.

Further findings about providers indicate that:
  • About one-half have completed their impact assessment—essentially the same number as in the October 2013 survey. About two-fifths responded ‘unknown’ or that they expect to complete this in 2015. Further analysis shows that the larger providers are mostly complete with this step, while the majority of smaller providers are unsure when they will complete their impact assessments.
  • About one-third of providers have begun external testing, while in the October 2013 survey about three-fifths had expected to begin by the middle of 2014. Over one-half responded either that they do not expect to begin external testing until 2015 or responded ‘unknown.’ Further analysis shows that for the larger providers over one-half had begun external testing, while for smaller providers most did not plan to begin external testing until 2015 or responded ‘unknown.’
For health plans and vendors, the results were somewhat more promising.

WEDI found that about 40% of vendors had completed product development—an improvement over results from the October 2013 survey. About two-thirds indicate that their products are already available, which is double from the prior survey. For health plans, 75% had completed their impact assessment and more than 50% had begun external testing. That's a marked improvement, compared to the prior survey, in which less than 25% had begun external testing.

Nonetheless, Daley warns HHS that unless all vendors, health plans, and providers continue to move forward in their efforts to get ready for ICD-10, "there will be significant disruption on October 1, 2015."

The letter points out other factors that are slowing industry progress including competing internal priorities and other regulatory mandates, and in the latest survey readiness of other entities was also identified as an important factor.

According to the letter, WEDI will continue to closely monitor industry progress and early testing results to gauge what might occur as the deadline approaches. The group strongly encourages "HHS to assist in promoting future ICD-10 readiness surveys, as that should lead to increased response rates and a more comprehensive view of industry readiness."

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