ICD-10: Mandate and Opportunity
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Slowdowns in care
While the ICD-10 mandate has many potential advantages, many leaders predict there will also be some disadvantages—especially at the outset.
Physician reluctance and a general learning curve for documentation and coding will severely slow down the process, Vogel says.
“Initially, it’s going to take more time, and anything increasing time is not improvement in care,” she says.
Vogel also worries about who will actually do the coding and documentation.
“There are just so many changes right now for everybody and physicians often just throw their hands up and hope someone else will do it for them,” she says. “I look for that to be the biggest issue: documentation and medical necessity.”
Although El Camino has long been preparing for the 2013 switch, Walton, too, anticipates a slowdown in care.
“Until the system adjusts, these new inputs and outputs might be a risk of a slowdown in certain aspects of care,” he says. “Excessive slowdowns in obtaining care or the care process is rarely a good thing.”
CentraState and many other organizations have gotten a jumpstart on preparing for ICD-10, but Ganguly believes staff training will be an ongoing process and last long after the October 2013 start date.
“The change has the potential to be very disruptive to clinicians in terms of their documentation processes and will require a great deal of training before the clinicians are comfortable with the new structure,” he says.
No one can be certain how long the slowdown in productivity could last, but Walton suggests that prepared organizations will be better able to react quickly.
“I suspect as soon as organizations understand that their processes are slowing down, they will react to correct the situation,” he says. “This will also depend on [factors] such as the regions of the U.S., patient and payer mix, and type of provider. So the recovery to full speed could take weeks or in some cases months.”
However, Walton doesn’t believe that quality of care will suffer as a result of any slowdowns.
“Care itself will be about the same—it is the financial expression, reimbursement, and information feedback cycles that will reflect the majority of the impact.”
There are other areas where the added costs of implementing ICD-10 may have a negative financial impact.
“The estimated costs for the ICD-10 conversion that are being put forward by major consulting firms is frighteningly high,” Ganguly says.
Additionally, Walton believes that ICD-10 will initially result in a 30% decrease in coding productivity.
“In other words, this effort will cost more well before clinical improvements might be detected,” he says.
But in the long term, most agree that the improvements to quality of care and available data will far offset the costs.
“It is costly, but how do you weigh that cost against the value of the patient experience and treating a patient?” Sornberger says.
This article appears in the November 2011 issue of HealthLeaders magazine.
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