Less than 5 percent of practices believe they have made significant progress in their overall readiness to adopt ICD-10, according to new research from MGMA, which indicates that progress to meet the Oct. 1, 2014 compliance date has been alarmingly slow.
According to MGMA, the primary concern is a lack of communication and critical coordination between physician practices and vendors regarding software updates and testing, which has not yet occurred.
“The transition to ICD-10, with its substantial impact on documentation of clinical care, physician productivity and practice reimbursement, is unprecedented,” stated Susan L. Turney, MD, MS, president and CEO of MGMA. “It is proving to be one of the most complex and expensive changes our healthcare system has faced in decades.”
MGMA’s research includes responses from more than 1,200 medical groups where more than 55,000 physicians practice.
Some of the key findings are as follows:
- Lack of response from vendors. More than 52 percent of respondents indicated they had not heard from their practice management system vendor regarding when software changes would be available to the practice. Almost 50 percent had not heard from their EHR vendor.
- Internal software testing lags. Only 5.9 percent of respondents reported that internal software testing has begun or is complete with their practice management software vendor and 4.7 percent with their EHR vendor.
- External testing delays. Just 11.9 percent of respondents reported that external testing with their clearinghouse has started or is complete. Almost 60 percent reported that they have not even heard from their clearinghouse regarding a testing date, and only 8.6 percent have started or have completed testing with their major health plans, with a concerning 70 percent stating that they have not heard from their major health plans.
- Low confidence for a successful transition. Nearly 60 percent of respondents stated they are “slightly” or “not at all confident” that their major health plans will be ready to meet the compliance date.
- Concern about changes to clinical documentation. Among a number of implementation concerns, 88 percent are concerned or very concerned about the expected changes to clinical documentation; 87.5 percent are concerned or very concerned about the loss of clinician productivity after implementation; and 81.1 percent of respondents indicated they are concerned or very concerned with the overall cost of switching to ICD-10.
- Absorbing costs for transition. Only 32.5 percent of respondents report that their cost to upgrade or replace their practice management system software will be covered by their vendor. Only 37 percent say their vendor will cover the cost to upgrade/replace their EHR.
- Cost of transition. For those organizations that must cover the costs themselves, the average cost for a 10-physician practice to upgrade or replace their practice management system and EHR software to accommodate ICD-10 is $201,690.
“A successful transition to ICD-10 requires coordination between providers and their vendor, clearinghouse and health plan trading partners. Our data suggest that many practices are in the dark in terms of moving forward with ICD-10 as this coordination has not yet occurred,” said Turney. “Without the necessary software changes and testing, practices will have no confidence that they will be paid for the care they deliver to their patients after Oct. 1, 2014.”
MGMA is calling on vendors, clearinghouses and health plans “to immediately release their implementation and testing schedules.”
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