The financial impact of ICD-10: How do you prepare for the unknown?

Of all the changes coming to healthcare in the coming years, conversion to the ICD-10 coding system might be the one with the biggest air of mystery. It's near impossible to tell exactly how it will impact revenue. No one's really sure how much training will be enough. Will systems and partners be ready? Will payers?

Inquiring CFOs would like to know.

FierceHealthFinance talked to Brent Grimes (right), administrative director of patient account services at Integris Health, an integrated system with four hospital in the Oklahoma City area. In part 2 of this exclusive interview, he discusses how the organization is preparing for ICD-10 implementation and how to manage through uncertainty.  

In part 1 of the exclusive interview, Grimes talked about how Integris is using data analytics to weather shrinking reimbursements and improve its collections strategy.

FierceHealthFinance: What's Integris doing to prepare for ICD-10?

Brent Grimes: We started over a year ago. I'm on our ICD-10 steering committee. We have clinical physicians and senior leadership all working together and we've divided into sub-committees for education, financial contracts, clinical. We're very concerned. We will be prepared: The software and applications and the clinical and the education.

My unknown is the payers and the clearinghouses. Their track record is not positive for being ready for anything. There were massive failures for 5010. I'm afraid we're going to see a long-term affect.

FHF: How do you prepare for the unknown?

Grimes: We can't just "roll with it." We're working with payers to contractually guarantee us payment. We look at an average monthly payment from our payers and have that contractually guaranteed. If they're not ready and prepared, we will not have a cash flow issue through that transition.

We were far from perfect with ICD-9. Documentation is critical. Our physicians have gotten better. Just talking about ICD-10 and how important it is has helped us today. Hopefully we continue that momentum and we're rocking and rolling when ICD-10 kicks off.

FHF: Are you spending a lot of money on ICD-10 training?

Grimes: Yes. The physician piece is very difficult. We have employed and non-employed physicians. The time management for physicians--fitting another issue into their time is difficult. We have marketing involved in that and physician sales. We offer CME credits to encourage them to come on board with education--any marketing niche within the rules and regulations.

FHF: How do you explain to docs the impact ICD-10 will have on their bottom line?

Grimes: The financial case goes back to their practices. This isn't just a hospital impact. This will financially hurt you, as well. Everyone will suffer.

FHF: Meanwhile, ICD-10 is not the only big change coming to healthcare. How do you stay on top of it all?

Grimes: A huge focus of our organization is the communication structure. It's vital, with all the changes coming, that you have a very open line of communication from the top down. We're Lean certified and our CEO and CFOs are very involved with Lean.

We send out email notifications about government regulations. We have leadership meetings at minimum once a month. The CEO and CFOs give that leadership and it's passed on through our departmental meetings and then filtered all the way through the department. It's non-stop communication.

It's the day-to-day operations and maintenance. It takes a lot of time. There's very little latitude to make a mistake right now with the cost of services going up and reimbursement going down. You have very little opportunity to take a risk.

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