Using ICD-10 to Gain Competitive Advantage

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Using ICD-10 to Gain Competitive Advantage

While at the WEDI conference in Austin, there has been some discussion about moving to the federally mandated ICD-10 code set not just for compliance, but for strategic advantage.

One of the presenters pointed out that compliance, accuracy and detail are components of the ROI, but there are also potential CMS imposed penalties looming in the future.  Pragmatists may be seeking a minimal cost, minimal compliance route, collaborators will seek a successful compliance but innovators – only about 15% of health plans – will see to win market share, improved operational costs, etc from strategic value.   As we move closer to the compliance dates, health care organizations will balance strategic advantage with risks of being out of compliance.

icd-10 adoption

chart shows how different organizations view adoption for compliance or strategic advantage

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By | 2017-05-04T04:07:03+00:00 February 4th, 2010|health care, health care reform, ICD-10, Innovation|0 Comments

About the Author:

Michael is Managing Partner & CEO of No World Borders, a leading health care management and IT consulting firm. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $4 billion in healthcare mergers and acquisitions. Education: UC Irvine – Economics and Computer Science, University of Southern California – Business, Stanford Medical School – Biomedical Informatics, Harvard Law School – Bioethics.

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