Recent reports show that ICD-10 may not break the bank as badly as the AMA once predicted, but the new code set still presents a number of challenges to financially vulnerable healthcare organizations.
ICD-10 has pushed hospitals and physician providers to evaluate their core competencies while preparing for infrastructure upgrades and training needs.
This, however, has led to revenue cycle issues and has put many providers in a bind. So, in order to deal with this issue, providers have been turning to specialized partners for clinical documentation improvement (CDI), revenue cycle management (RCM), and expert coding advice. According to EHR Intelligence,"a new Black Book estimate projects that the RCM outsourcing market will grow from $7.7 billion to $9.9 billion by the middle of 2016." In looking at this data, the big question is: will these efforts help providers overcome the financial impacts of the ICD-10 switch, and how much will they help?
ICD-10 is a hot topic, and it is shaking up the healthcare industry. This new code set and the constant changes and the recent delay are causing many providers stress and anxiety. These providers are trying their best to recover from the one-year delay that set ICD-10 back until October 1, 2015. Also these organizations are still having to learn how ICD-10 and the new billing will affect their financial situations. Outsourcing seems to be the answer for some providers, but it is still unclear as to how much this helps. EHR Intelligence noted some data that show outsourcing's impact: "Outsourcing of RCM activities has already produced similar gains in revenue, Black Book adds. Around 80% of hospitals that have pushed most of their RCM activities towards external partners have seen about a 6% increase in revenues during 2014, which may help to mitigate any losses that result from the steep declines in productivity and timely billing predicted to accompany the ICD-10 transition."
EHR Intelligence also found "that twenty percent of hospitals that have recently embraced RCM outsourcing are still critically afraid that they are facing closure or bankruptcy within the next four years if their RCM technology, in-house or outsourced, isn’t cutting edge." Needless to say, ICD-10 is a big change, and it can raise concern over finances and organizational management procedures.
We don't know if RCM outsourcing is the answer, or the sole solution to the problem. But, working as an organization to anticipate any financial impact of ICD-10 would be a good precautionary measure. Also, medical scribe services may also benefit the financial health of your organization. A scribe program and RCM outsourcing could be the answer. This complex issue is unique in nature and each organization will be impacted differently. Stay up to date on ICD-10 and how to prepare. We will feature more posts on ICD-10...stay tuned!