In 2010, a study was conducted by Georgetown University and Booz Allen Hamilton to define trends, challenges and lessons learned surrounding the implementation of ICD-10 and to provide actionable information to serve as a resource for organizations navigating the transition. The participating health care organizations were large hospitals, integrated health care systems and other national leaders who were likely to have initiated the process far in advance of the October 2013 deadline. Interviews were conducted with employees of seven health care organizations in March and April 0f 2010. Among the trends and challenges identified by these organizations identified were:
- Each organization had appointed project managers and steering committees to monitor the transition
- Five organizations were in the early stages of impact assessments
- Five of the organizations had yet to budget significant funds
- The organizations reported difficulty creating a sense of urgency among staff concurrently dealing with the transition while managing other recently implemented regulations
- Four organizations reported difficulty in raising awareness among physicians
- One organization reported difficulty locating timely and accurate information about the transition
- Three organizations reported difficulty staffing the transition
Fast forward to a KLAS survey of 163 health care providers conducted in October 2011. Progress in the intervening time has apparently not been significant particularly in some of the same areas identified in the 2010 survey. The KLAS survey found that less than ten percent of healthcare organizations are over halfway to being fully prepared for ICD-10. A lack of understanding regarding how extensive transition to ICD-10 is persists. And while most know the transition will be costly, the survey also found that many providers had yet to establish an ICD-10 budget.
Across the organizations surveyed, more than half of the respondent (54%) indicated that training was their number one concern and physician and nurse readiness also ranked high at 44%. Nearly two thirds (65%) of organizations also expect to use 3rd party firms to help them prepare. The longer they wait the more difficult and costly it will likely be to find qualified resources.
Possibly in response to this widespread lack of preparedness, as well as pushback by the American Medical Association, Marilyn Tavenner, Acting administrator of the Centers for Medicare and Medicaid Services (CMS) announced at an American Medical Association conference held in Washington, DC on February 14, 2012 that CMS now intends to re- examine the timeline for the switchover to the new code-set. A key factor may be current problems implementing the 5010 transaction set which is a prerequisite for ICD-10. The Medical Group Management Association (MGMA) also recently asked CMS to postpone enforcement of the 5010 set to June 30 because a large number of physicians are encountering payment delays due to the transition.
Regardless of deadline, for some organizations no amount of time will ever be sufficient. As the deadline draws closer the pushback is likely to continue and potentially increase in intensity. Should CMS implement a delay? If so, how long is long enough?