HealthCare Administrative Solutions, Inc. ICD-10 Provider Preparedness Annual Survey Results

Transcription

1 HealthCare Administrative Solutions, Inc. ICD-10 Provider Preparedness Annual Survey 2013 Results HCAS December 2013

2 Introduction To help providers meet the ICD-10 compliance date of October 1, 2014, Massachusetts health plans and MassHealth conducted its third annual online ICD-10 provider preparedness survey to review preparedness efforts since the last survey was issued in late The results provide a baseline for statewide compliance efforts underway in the provider community and will be used by health care organizations to develop education strategies and to identify ICD-10 resources as the provider community prepares for the enactment of ICD-10 codes next year. To avoid duplicate survey requests from various health care organizations, HealthCare Administrative Solutions (HCAS) administered this survey on behalf of the following organizations: Blue Cross Blue Shield of Massachusetts Boston Medical Center HealthNet Plan Fallon Community Health Plan Harvard Pilgrim Health Care Health New England MassHealth Neighborhood Health Plan Network Health Tufts Health Plan HCAS would like to thank the organizations involved in the outreach efforts including individual health plans, the Massachusetts Health Data Consortium, the Massachusetts Medical Society, the Massachusetts Hospital Association, the Massachusetts Health Information Management and the Massachusetts Group Management Association. -A-

3 Executive Summary The survey was issued to the Massachusetts provider community and consisted of a series of questions designed to assess ICD-10 planning and preparations underway within the provider community. The survey response period was four weeks in duration and various communication methods were used to encourage participation including use of statewide newsletters, and other means available during the survey period. Results include the following: Total survey responses: 374 A majority of response were received from the following: Physician Offices (40.1%) Other Providers (29.9%) which included solo practitioners and specialty providers Allied Health Providers (8.0%) Total number of hospital responses received: 37 Total number of integrated health care organization responses received: percent of the responses were submitted by organizations with fewer than 10 employees. Development of training and implementation plans were the most common activities reported as in process or completed by providers. Lack of knowledge, staff and training capacity and clinician engagement were noted as the top barriers in ICD-10 planning and implementation work. 69 percent of responses noted that changes in claims processing and coding guidelines were needed from payers. 46 percent of providers expect to be ready for external testing with payers between July and September of percent of providers indicate that they were somewhat or very likely to submit ICD-10 compliant transactions by October 1, s to each of the survey questions are included on the following pages of this report. For additional information about HealthCare Administrative Solutions (HCAS) and administrative simplification projects, please visit HealthCare Administrative Solutions, Inc. (HCAS) is a non-profit entity founded by several Massachusetts health plans to collaborate on administrative simplification initiatives. Participating organizations include Blue Cross Blue Shield of Massachusetts, Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Medical Network, Neighborhood Health Plan, Network Health and Tufts Health Plan. -B-

4 HCAS ICD-10 Provider Preparedness Survey #3 1. In what ZIP code is your primary location? (enter a 5-digit ZIP code, ex or 94305) 374 answered question 374 skipped question 0 2. What type of organization do you represent? Hospital 9.9% 37 Integrated Health Care Organization 2.7% 10 Multiple Physician Office 18.2% 68 Individual Physician Office 21.9% 82 Allied Health Provider (i.e. PT, OT, Optometry) 8.0% 30 Mental Health Facility 3.2% 12 Ancillary Services (Ambulance, Pharmacy, Laboratory) 2.9% 11 Clinic/Health Center 3.2% % 112 answered question 374 skipped question 0 1 of 13

5 3. Choose the category that best describes the department you work in at your organization. Billing/Coding/Patient Accounts 22.7% 85 Information Technology 2.1% 8 Health Information Management 7.0% 26 Administration (i.e., Office Management, Biller, Medical Secretary, etc.) 29.4% 110 Individual Practitioner 31.6% 118 Clinical Function 3.5% % 14 answered question 374 skipped question 0 2 of 13

6 4. What is your role in your organization? Doctor 15.8% 59 Nurse 1.1% 4 Other provider of services 14.2% 53 Office Management (Supervisor, Financial Director, etc.) 34.0% 127 Medical Coder 5.6% 21 Project Manager 2.7% 10 Patient Accounts Staff 1.6% 6 Office Staff 6.4% 24 ICD-10 Project Team Member 5.6% % 49 answered question 374 skipped question 0 5. What is the size of your organization? Include all staff members. Under 10 staff members 54.0% staff members 25.4% 95 Over 100 staff members 19.5% 73 Do not know 1.1% 4 answered question 374 skipped question 0 3 of 13

7 6. What is the current status of the ICD-10 preparations at your organization? Please select responses below that are in process or completed? (Check all that apply) Impact analysis 26.3% 69 Mapping strategy 14.1% 37 Impact analysis AND mapping strategy 22.9% 60 Allocated resources 24.0% 63 Implementation plan 39.3% 103 Communication plan 32.4% 85 Training plan 46.9% 123 Business requirements 27.5% 72 System development 24.0% 63 Testing strategy 15.6% 41 Workflow changes 21.8% 57 Deployment plan 12.2% 32 answered question 262 skipped question of 13

8 7. Select the appropriate stage if the current status is either Impact Analysis or Mapping Strategy. Not started 56.3% 98 Planning stage 24.1% 42 In process 13.2% 23 Completed 6.3% 11 answered question 174 skipped question Select the stage if the current status is BOTH Impact Analysis and Mapping Strategy. Impact Analysis Mapping Strategy Rating Not started 20.0% (1) 80.0% (4) 5 Planning stage 31.6% (6) 68.4% (13) 19 In process 30.0% (6) 70.0% (14) 20 Completed 50.0% (1) 50.0% (1) 2 answered question 35 skipped question of 13

9 9. Indicate the top barriers that your organization faces in its ICD-10 planning and implementation work. *Please select the top 3 barriers. Clinician engagement 35.1% 110 Significant business impact 20.4% 64 Significant technical/it impact 25.2% 79 Staffing and training capacity 41.5% 130 Competing priorities 33.2% 104 Lack of knowledge 47.9% 150 Funding constraints 17.6% 55 Vendor/trading partner readiness 22.4% 70 Lack of executive sponsorship 2.6% 8 6.7% 21 answered question 313 skipped question 61 6 of 13

10 10. How likely will your organization be ICD-10 ready by the compliance date of October 1, 2014? Very likely 45.7% 144 Somewhat likely 31.4% 99 Not likely 3.8% 12 Do not know 19.0% 60 answered question 315 skipped question What tools will your organization use to code in ICD-10? Cheat sheets 12.5% 38 MD notes 3.9% 12 Conversion tool/crosswalk 29.2% 89 Clinical notes 13.4% 41 Medical records 10.8% 33 Coders 17.0% % 40 answered question 305 skipped question 69 7 of 13

11 12. When do you expect to have your IT system(s) ready to process claims using ICD-10 codes? Completed 7.4% 20 Oct-Dec % 15 Jan-Mar % 51 Apr-Jun % 52 Jul-Sep % 132 answered question 270 skipped question When do you expect to have your operational processes ready for ICD-10 codes? Completed 4.5% 13 Jan-Mar % 37 Apr-Jun % 59 Jul-Sep % % 34 answered question 288 skipped question 86 8 of 13

12 14. When will your organization be ready for external testing with payers? Oct-Dec % 10 Jan-Mar % 39 Apr-Jun % 56 Jul-Sep % % 49 answered question 285 skipped question Has your organization developed an internal ICD-10 education/training plan? (i.e. vendor support, resources, scheduling) Yes 13.9% 43 No 43.5% 135 In process 34.8% 108 Do not know 7.7% 24 answered question 310 skipped question 64 9 of 13

13 16. What approaches/tools are you using for staff training? Vendor resources 30.7% 47 In-house resources 32.7% 50 Conferences 23.5% % 20 answered question 153 skipped question If using a vendor, please supply name below. 37 answered question 37 skipped question of 13

14 18. What information would you need from payers to assist in your ICD-10 efforts? Please rank the level of importance of each item. Not important Somewhat important Important Very important Rating Average Rating ICD-10 implementation plans 4.6% (12) 11.1% (29) 36.6% (96) 47.7% (125) ICD-10 implementation schedule 3.4% (9) 7.5% (20) 33.5% (89) 55.6% (148) Mapping information 7.3% (18) 11.3% (28) 35.6% (88) 45.7% (113) Crosswalk information 5.9% (15) 6.7% (17) 34.1% (87) 53.3% (136) Changes in processing (ex. claims, referrals) 1.5% (4) 3.0% (8) 26.2% (69) 69.2% (182) Payer specific information by specialty 1.9% (5) 5.4% (14) 26.5% (69) 66.2% (172) Coding guidelines 0.8% (2) 2.3% (6) 27.5% (73) 69.4% (184) Updated medical policies 3.6% (9) 11.2% (28) 37.8% (94) 47.4% (118) ICD-10 test plans 3.1% (8) 10.0% (26) 30.1% (78) 56.8% (147) answered question 275 skipped question of 13

15 19. What would be the preferred method(s) to receive information from payers? Select two methods from the list below. On-line manuals and other resources 70.5% 198 Educational tools 35.6% 100 Webinars 59.8% 168 Open forum sessions 20.3% % 16 answered question 281 skipped question If your organization may not be ready by the compliance date of October 1, 2014, does your organization have a contingency plan? Yes 7.2% 19 No 50.2% 133 In process 10.2% 27 Do not know 27.5% % 13 answered question 265 skipped question of 13

16 21. Please provide any additional comments that you may have regarding ICD-10 preparations. 55 answered question 55 skipped question Please provide your name, contact information and your ICD-10 lead's contact information if you would like to receive future ICD-10 communications. Name: 99.1% 214 Company: 89.4% 193 Address: 100.0% 216 Phone Number: 92.1% 199 answered question 216 skipped question of 13