Physician practices still not in 5010 ballpark as deadline looms

A recent MGMA survey of physician practices makes clear that a large percentage will have trouble meeting the Jan. 1, 2012 deadline for using the HIPAA 5010 transaction set. MGMA, which represents 13,600 organizations--including 280,000 physicians--has asked the government to consider instituting "an appropriate contingency plan to avoid widespread cash flow disruption in the industry" if providers and payers don't speed up 5010 preparations. There's no indication, however, that the Department of Health and Human Services will heed this warning.

Forty-five percent of responding practices said they had yet to begin 5010 implementation, while 46 percent said they had done part of the necessary software upgrades, and only 2 percent had completed implementation.

What's more, 9 percent of respondents had begun internal testing of the new software; 41 percent said they planned to do testing between March and December, while 38 percent had not scheduled testing. Additionally, only 3 percent of the practices had started testing 5010 data exchanges with their major health plans. About half of all respondents had yet to scheduled testing with any payers.

A communication gap with software vendors also existed. While 50 percent of respondents believe their software will have be to be upgraded, and 5 percent think it will have to be replaced, more than 30 percent of respondents hadn't received any communication from their vendors in regard to the 5010 changeover.

MGMA urged both payers and software vendors to increase their efforts to work with practices to implement and test applications capable of handling 5010 transactions.

One major obstacle to the 5010 implementation is cost, according to many respondents. Practice management executives estimated it would cost about $16,500 per physician to upgrade systems for the 5010 set, which will be required for the changeover to the ICD-10 diagnostic code set in 2013. 

To learn more:
- read this MGMA announcement
- check out the survey results (.pdf)