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Posts Tagged ‘ICD-10’

ICD-10: Nine tips to decrease cash flow disruptions

T-minus 9 months!  Are you ready for ICD-10?  Are you really ready?

The Health Information Management Systems Society (HIMSS) Annual Conference is being held in Orlando, Florida this year and I would guarantee that the educational sessions on ICD-10 will be packed with healthcare providers seeking the answer to this very question.  On the other hand, some providers may feel very confident that their organization is ready for the October 1st change.  In fact, being so close to Disney World, they may be singing, “Hakuna Matata” (Disney’s The Lion King song, meaning, “no worries”), through the conference hall thinking that because their organization has performed ICD-10 readiness assessments, developed detailed project plans for implementation and begun the remediation process, they are good to go.

ICD10 Readiness - Minimizing Impact to the Bottom LineHowever, before they start hitting any high notes and doing a dance, they should make sure that they have not only taken the necessary steps to fully understand the impact ICD-10 will have on their workflow and documentation practices, but also to their bottom line.  Healthcare organizations need to understand that “As part of a holistic risk mitigation strategy, providers must understand and be able to forecast possible changes to cash flow and engage in advanced planning to protect revenue losses before, during, and post ICD-10 conversion1.”

According to results from a poll conducted by firm KPMG, 76 percent of providers have completed an impact assessment for ICD-10 and 72 percent had set aside a budget to prepare for readiness2.

“As October 1st inches closer, healthcare organizations have their work cut out to properly absorb the impact that the new coding will have on their businesses,” said Wayne Cafran, an advisory principal in KPMG’s Healthcare & Life Sciences practice. “A full 50 percent stated that they had yet to estimate the new coding system’s impact on their cash flow. With estimates by those who did measure the impact tallying anywhere from $1 million to more than $15 million, healthcare organizations are in for a rude awakening when they finally realize what the new standards will have on their bottom lines1.”

Tips to protect your bottom line

ICD-10 implementation is fast approaching, and providers need to take aggressive steps to ensure that their efforts focus on adequately assessing the potential cash flow problems that may arise after October 1.  Don’t start panicking just yet.  Here are 9 tips, from Beth Mahan, to calm the panic and help mitigate the potential impact to your bottom line1

  1. Discuss budgeting avenues for additional cash reserves if material delays in payment occur.
  2. Conduct financial modeling to understand financial implications moving from ICD-9 to ICD-10 and determining the revenue impact by provider or system facility, service line and geography.
  3. Review managed care contracts to negotiate protective language relevant to reimbursement in the event payment shifts occur that could have a negative impact on your bottom line.
  4. Engage with your high-volume payers to assess their readiness state to process your claims coded in ICD-10
  5. Conduct clinical documentation improvement reviews using ICD-10 code set.
  6. Develop a strategy for coding, billing and claim backlogs to improve cash flow.
  7. Determine strategy for denials management pre- and post-ICD-10 conversion.
  8. Assess readiness state of external vendors who support coding, billing, follow up and denials.
  9. Review audits occurring that may be impacted by compliant use of ICD-10 over time.

If your organization has truly taken the necessary steps to mitigate the risk to its cash flow, then I would recommend that the organization perform an internal audit for ICD-10 implementation and compliance to assure that when October 1st comes you really are set.  Taking the aforementioned steps plus this extra step can bring your organization peace of mind and save you big bucks in the long run.

Then when asked, “Are you really ready for ICD-10?” you can really sing, “Hakuna Matata!”

 

Will you be HIMSS?

Meet Priyal and the rest of our healthcare team at Booth #2035. Contact us to set up a meeting.

himss14_top

Resources for this blog post:

  1. http://www.govhealthit.com/news/icd-10-revenue-neutrality-9-ways-protect-your-cash-flow
  2. http://www.nuemd.com/news/2014/01/13/providers-lack-understanding-icd-10-revenue-impact/
  3. http://www.successehs.com/item/6-tips-to-protect-cash-flow-during-the-icd-10-transition.htm

The Value in Voice-Natural Language Processing in Healthcare

Guilty!  I text while I drive…eek!  I know, I know, it is really bad and those anti-texting and driving commercials get me too.  That is why I am making a concentrated effort to ease up this one vice (stop laughing those that know me!) of mine.  Instead, I am beginning to use the voice text option and good ole Siri on my phone, which when I speak like a robot and articulate every word, does alright.  But old habits die hard, which is why I understand and sympathize with physicians constantly having to change their behavior in light of all the regulatory demands in recent years.

One behavior that physicians are being asked to change is their practice patterns of dictating or handwriting clinical notes and discharge summaries.   The change comes from the desire to move away from unstructured data to more structured data for consistent, easily minable and extractable information for more robust and quality NLPreporting and analytics.  80% of clinical documentation that exists in healthcare today is unstructured and is buried in electronic medical records (EMR) and clinical notes1.  Many healthcare providers are looking to natural language processing (NLP) technologies to assist in taking their valuable unstructured data, and turning it into meaningful and actionable structured data to improve patient care.

Natural Language Processing and Clinical Language Understanding

In its simplest definition, NLP is the interaction between artificial intelligence and linguistics.  It encompasses anything a computer needs to understand typed or spoken language and also generate the language2.  More specifically, NLP applied to the medical domain is called Clinical Language Understanding (CLU), with the main difference being that CLU works off of a complete, highly granular medical ontology, which has been tuned to relate and identify all kinds of medical facts so that the underlying NLP engine can “understand” what the caregiver is saying1.  NLP has been around for years, but it wasn’t till recently that healthcare industry took notice of the value of this effectively powerful technology.

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Top 5 Technology Trends in Healthcare – October 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

 HCBlog Top5 Trends

Mobile Medical Applications

Last month, the FDA released its final guidance for developers of mobile medical applications. The FDA will focus on regulating potentially harmful apps instead of policing applications that pose minimal risk to consumers. These more harmful apps include those which are using mobile technology to make a specific diagnosis and those which transform mobile devices into a regulated medical device.

Patient Engagement and Connected Health

With the progression of patient engagement, consumers are looking to become involved in their own care and health. The quantified-self movement helps patients track their health, physical activity, food consumption, heart rate, and more. From mobile apps to worn digital sensors like the FitBit to implanted devices, patients keep track of their own health data – which eventually may be used to create a more personalized experience.

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Top Technology Trends in Healthcare – June 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

ACOs and Patient Centered Medical Homes

An ACO is a group of healthcare providers that partner under a payment and delivery reform model that become collectively accountable for the full continuum of care for a population of patients. This reform model ultimately ties reimbursement to quality metrics and reductions in the total cost of care for the patient population. Patient Centered Medical Homes (PCMH) focus on improving the quality of care delivered by creating a health care environment that facilitates communication between the patient and their physician, allowing patients to receive and understand the care they need when they need it.

Telehealth and Remote Patient Monitoring

The healthcare industry is experiencing revolutionary changes stemming from the rapidly shifting role of the patient within the continuum of care. This is resulting in high demand for easier access to healthcare professionals, access to online medical information, and alternatives to traditional care. Telehealth allows for the transmission of medical images, video, audio and information related to diagnosis and treatment can be stored and sent from the provider’s computer or mobile device via secure data exchanges. Remote Patient Monitoring allows patient’s health data to be sent electronically to a provider who then can analyze it and respond with appropriate recommendations.

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ICD-10 Impact on Productivity – Offensive vs. Defensive Game

Chicago Bulls win the NBA Championship and ICD-10 has been postponed!  Just kidding.  However, as much as I am hoping for the former, I am sure many healthcare organizations are hoping for the latter.  Unfortunately the chances of that happening are as slim as me becoming a Miami Heat fan!  One thing is certain, when ICD-10 kicks in on October 1, 2014, productivity will take a hit.  If you want to come out winning (least impact), you better come prepared with your offensive game.

Areas of Impact

Clinical Documentation – With the increase in granularity of the ICD-10 codes, there will be an increase in the amount of information that a provider must include in the patient record.  This will directly impact the time spent on each patient encounter.  Things that a provider may not have needed to capture with ICD-9 are now being required with ICD-10.  For example, things such as1:bball ICD-10

  • Type of encounter (initial or subsequent)
  • Applied specificity (did the patient lose consciousness?)
  • Acute versus chronic
  • Relief or non-relief (intractable versus non-intractable)
  • External cause (what caused the accident?)
  • Activity (what was the patient doing when she was injured?)
  • Location (where was the patient when she was injured?)

According to a study conducted by Nachimson Advisors, LLC, the move from ICD-9 to the ICD-10 will increase documentation activities about 15 percent to 20 percent2. This is not just an implementation or learning curve increase.  This translates into a permanent increase of 3 percent to 4 percent of physician time spent on documentation for ICD-102.  Those providers thinking that their electronic health record (EHR) will eliminate extra documentation time are sadly mistaken.  Many templates within in the system itself will need to be changed to accommodate the new codes sets resulting in additional work.

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Webinar: Maintaining Revenue while Implementing ICD-10

The Centers for Medicare & Medicaid Services have spoken: October 1, 2014 remains the deadline for ICD-10 transition. Counting on another one-year extension is no longer a viable strategy, and delaying implementation can cause your organization to miss out on the cost and care improving benefits.

While ICD-10 implementation can be challenging and places new demands on the provider community, it also opens up remarkable opportunities for providers. Deeper data means better tools to improve care and lower costs.

Join experts from Perficient and Edifecs for an informative discussion of ICD-10:

  • ICD-10’s real impact to the provider community
  • How analytics can help achieve intelligence in ICD-10
  • Ways to identify, mitigate and prioritize risk
  • Best practices for achieving ICD-10 compliance
  • Assuring revenue up to and beyond the October 2014 deadline

Register Now!

Want to learn more about ICD-10? Download complimentary white papers from Perficient and Edifecs: The HIT Trifecta: Meaningful Use, 5010 and ICD-10, Implementing ICD-10: Hard Work Brings Rewards and Achieving ICD-10 Compliance from Any Stage.

Top 5 Technology Trends in Healthcare – April 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.HCBlog Top5 Trends

Mobile Health

Healthcare organizations have embraced mobile technology, as it streamlines healthcare, provides immediate access to important patient information, and allows for increased coordination across the continuum of care. Patients and members are able to easier access healthcare professionals, online medical information, and care alternatives to contain costs and improve quality by using mobile technology.

Interoperability

Interoperability plays a key role in ensuring systems can communicate with each other to share information. It helps to reduce redundant data entry, speed access to information and create a real-time flow of information through an enterprise IT system. The key benefit of creating interoperability is to improve the visibility, sharing and re-use of data collection between disparate healthcare applications and devices.

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Investing in Change Management to Drive Healthcare Outcomes

I attended a session at the HIMSS 2013 Conference yesterday entitled, Healthcare Kaizen, Daily Improvement, Not Just Events that Mark Graban, MSME, MBA, presented.  At a technology conference it was refreshing to hear how technology should not be the only focus to improving care.

In today’s healthcare environment, big strategic initiatives are all the rage.  Business Intelligence, ICD-10, Meaningful Use, Patient engagement, ACO, pick your flavor.  All these things have one common goal-improve healthcare outcomes, be it patient care, cost reduction or increase in operational efficiencies.  Given the financial incentives tied ppblogto many of these larger healthcare initiatives, many organizations are investing millions of dollars in technology to help them achieve the aforementioned.  But what most organizations don’t realize is that you need to invest not only in technology, but in the people and processes within the organization to drive optimal care.

You can implement all the latest and greatest technology in the world but until there is some level of change management associated with people and processes the true goal of improved outcomes will never be fully achieved.  Just as technology needs to be updated, people and processes need to undergo continuous improvements.   As Mr. Graban pointed out in his presentation, the practice of Kaizen and Lean Healthcare is encouraging and offering structure to this much needed change.

Though change is inevitable, it is never an easy task.  Just as it is difficult to implement technological change, so is changing behavior.  Peter Scholtes once said, “People don’t resist change, they resist being changed.”  Therefore, it is up to healthcare organizations and its leadership to understand the positive impact of investing in its people and processes.  Without doing so, in a non-threatening manner as Mr. Graban pointed out, optimal patient care is just a mere thought.

Top 5 Technology Trends in Healthcare – February 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

Will you be attending the HIMSS 2013 Conference next week? Come see us in Booth 1555!

HCBlog Top5

Patient Engagement under Meaningful Use

A key theme of Stage 2 meaningful use is engaging patients in their own care. Building on the Stage 1 requirement that 50% of patients be able to view their documents electronically, Stage 2 mandates that 10% of those patients actually do so. Clinical summaries must be provided following each office visit and select patients will receive notifications and reminders for additional care. Secure messaging to patients, another Stage 2 requirement, can connect them with helpful care information.

Population Health Management

PHM is a concept that includes the healthiest and the sickest individuals by improving the overall health of high- and low risk patients by addressing personal health behaviors that may contribute to health through care, communication and education.  PHM places an emphasis on primary care to provide preventative, acute and chronic illness care, which is coupled with efforts to educate patients and encourage behavior and lifestyle changes.

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Providers and the Adoption of ICD-10

There are two areas of focus in the ICD-10 conversion, each of which must be remediated/completed by October 1, 2014.  Our initial thoughts, urges and efforts are towards technology or those systems that we must now use to do our jobs.  Said another way, we need to update/upgrade the transactional systems, applications, and data repositories we use to conduct business and exchange transactions with our various business partners.  This approach is typical.  Dust off or complete (the latter in most cases) an inventory of all impacted systems, vendors, reports, databases, files, etc…  Review the lists to determine the impact, work with vendors, and deploy updated versions of software and so on.  Not necessarily the easiest thing to do, but we’ve all had to do this multiple times in the past and the IT folks will take care of it.  Wait a minute you say!  Backup, I just covered a great deal of ground too quickly on something that can weigh heavily on most organizations, given everything else going on, to handle.  You’re right, I could devote blogs to just this topic alone.  But I think that’s the easy part, or at least it should be.

The second area of focus, and the one of greater impact and importance, is that which covers a provider;s standard of care, clinical document standards and practices employed by its healthcare professionals in the delivery of care.  It’s that which we have deployed technology to enable!  What is captured in patient records and clinical documents today is driven by what’s needed in order to submit for reimbursement.  Healthcare Reform has something else in mind, something longer term.  We’ve begun the effort to turn the Titanic away from an instance of care focus to the longitudinal or continuum of care and the accompanying outcome.  I would challenge each provider to examine their standards and to compare the current requirements for documentation of an encounter or patient services against what will be needed to adequately code a claim for ICD-10.  I would be surprised if more than half the encounters coded to a bill in a hospital today under ICD-9 will have sufficiently detailed records to do so under ICD-10.  The current “system” has been unduly constrained around the ICD-9 code set due to its longevity and focus on the here and now.  Very few healthcare professionals can recall anything other ICD-9, nor the challenges that were experienced when it was adopted so long ago. Read the rest of this post »

The Top 5 Healthcare Posts of 2012

The past year was very busy for the Perficient Healthcare team, and our blog reflects the time and hard work our group has put in. Throughout a year of healthcare reform, regulations implementation, and numerous deadline changes, we’ve worked to keep our subscribers in the loop. As we start another busy year, here is a look back at the top 5 most viewed blogs from 2012:

  1. Is it time for Open Source in Healthcare? As several key players in open source software develop, do we need to re-evaluate potential IT architectures? These solutions hold the potential to reduce cost pressures in healthcare IT.
  2. From Little Data to BIG Data – One Step at a Time One of the key building blocks to creating an ACO is data analysis. So how do we get from the unorganized data we have to the big data we’ll need?
  3. Clinical Documentation – The Make or Break Component of ICD-10 With the ICD-10 deadline determined this year, implementation was high on many people’s minds. The Clinical Documentation Assessment is a great building block to start these looming projects.
  4. ICD-10 Revenue Neutrality: A Strategic Approach ICD-10 was clearly a hot topic for many in 2012. In order to achieve Revenue Neutrality, Health Plans and Providers must work together to set up reasonable objectives.
  5. Data Governance vs. Data Management The terms Data Governance and Data Management are closely related but still very different ideas. So what are they, and how do you know which is which?

In addition to these top 5 viewed posts, we have also published several successful Monthly Trends Reports, which we will continue to do in 2013. Stay tuned for another great year of content!

Top 5 Technology Trends in Healthcare – October 2012

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

 

EHR/Meaningful Use Stage 2

Meaningful Use is a set of standards that ensures Electronic Health Record systems are being used meaningfully, in order to improve the quality of care. Stage 2 of meaningful use has a primary theme of interoperability between EHR systems and engaging patients in their own care.

Health BI/Big Data

Healthcare business intelligence can provide organizations the ability to use their data to improve quality of care, increase financial efficiency and operational effectiveness, conduct innovative research and satisfy regulatory requirements. Analytics can provide the critical insights in meeting the organizations’ goals and gain competitive advantage.

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