ICD-10’s Momentum can Help Physicians Meet New Revenue Cycle Goals
By Jim Denny
For the past several years, the industry was inundated with warnings about the impending ICD-10 transition that finally occurred October 1, 2015. There were warnings that productivity would be impaired, and that the financial health of physicians could suffer with the anticipated increase in denials and rejections. As the implementation deadline came and went, however, the industry pulled off a relatively smooth and successful transition.
According to Navicure’s ICD-10 post-implementation survey of healthcare leadership, 60 percent of respondents didn’t see any impact on monthly revenue following the transition date. Another 34 percent only saw their revenue decrease by less than 20 percent. In addition, respondents only saw a 13-percent decrease in administrative staff productivity and a 15-percent decrease in clinical staff productivity.
In light of the predictions for a rocky ICD-10 transition, how did physicians achieve success? The right strategy, technology, and preparation plan certainly contributed, but another essential factor was drive: Everyone in healthcare knew ICD-10 would require substantial changes, and everyone knew the consequences for unpreparedness would be severe. Physicians, along with other key players such as payers and technology vendors, worked together and worked hard. In the end, this drive enabled physicians to beat industry predictions about lost productivity and revenue.
Ninety-nine percent of participants in the survey indicated they were ready for the transition on October 1, which was 14 percent higher than the sentiment in August 2015. These metrics show how physicians stayed on task and gained the momentum necessary to achieve their ICD-10 goals, and are consistent from even earlier studies to measure readiness confidence.
As physicians turn their focus toward new priorities, 2016 presents a great opportunity to leverage the same drive that made them successful with ICD-10. Consider these results and corresponding best practices:
- Two-thirds of survey respondents indicated they plan to work on improving overall RCM processes. Claims management was a key part of ICD-10 transition planning, and physicians can continue this momentum by using business intelligence to pinpoint problem areas and set improvement goals. Monitoring key performance indicators such as charge lag, days in A/R and denial and rejection rates can show providers exactly where they need to focus, enabling them to improve processes and staff performance.
- Another top priority included working toward a value-based care model (15 percent). The switch from volume to value is well underway, and physicians can benefit from putting all processes under a microscope to ensure they’re achieving both efficiency and effectiveness. In addition to leveraging BI, physicians should ensure ongoing analysis is a priority — and part of the organizational culture.
- Physicians also identified revamping patient collections strategies (nine percent) as a key goal following ICD-10 implementation. As patients adjust to paying a larger portion of their healthcare costs, two components of a patient collections strategy are particularly important – providing price transparency via pre-service or time-of-service estimates and making arrangements at time of service to collect balances in full, ideally both utilizing automated solutions to streamline efforts.
While none of these initiatives have a hard deadline like that of ICD-10, they’re essential to the financial health of physicians. They’ll require ongoing drive and strategic focus; fortunately, with ICD-10’s success, physicians have already proven they’re up for the challenge.
Jim Denny is president and CEO of Navicure in Atlanta.