December 1, 2015 Owen Carey

KPMG Survey: ICD-10 Transition “Fairly Smooth”

Only 11 percent of healthcare organizations described the ICD-10 transition as a “failure to operate in an ICD-10 environment,” according to KPMG LLP survey. The survey of 298 attendees of the Nov. 9 Webcast, ICD-10: Just the Beginning, found 80 percent of organizations said the ICD-10 transition has proceeded smoothly. 28 percent stated the ICD-10 transition has been smooth and another 51 percent found “a few technical issues, but overall successful.” 

“While there seems to be a fairly smooth transition to ICD-10, the 11 percent of organizations that are struggling need to be helped,” said Todd Ellis, managing director at the tax, audit and advisory firm.. “The communities these organizations serve depend upon their healthcare providers to meet their medical needs and we need to help them through these challenges. ICD-10’s implementation was a lengthy process and unfortunately they will address these issues or face greater competitive disadvantages in measuring quality and reduced cash flow.”

Key Findings

Largest Challenges to ICD-10 for Providers

Survey respondents said the largest challenges they see with ICD-10 include rejected medical claims, clinical documentation and physician education, reduced revenue from coding delays and information technology fixes. The survey found 42 percent of respondents said all of these challenges are part of ICD-10. Only 11 percent of claimants said they did not expect those challenges to arise.

Post ICD-10 Initiatives

With ICD-10 going live, 46 percent of respondents said they were thinking of pursuing initiatives in clinical documentation improvement, revenue cycle optimization, and electronic health record and IT system optimization.  The survey found that 25 percent were pursuing none of those options.

Cash Flow Impact

Along with the investment in time, money and technology among healthcare organizations, the transition has been beset by delays impacting the bottom line of many healthcare organizations. “Organizations are beginning to see dips in cash flow due to payers delaying the processing of ICD-10 claims while they ensure their ability to appropriately adjudicate these claims, while others are seeing an increase in claim denials over pre-ICD-10 levels” said Craig Greenberg, KPMG director, advisory. Greenberg’s comments focused on the long-term impact upon profitability that revenue cycle management can have upon providers.

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