Health care providers can help minimize the downside cash flow and revenue impacts of ICD-10 by organizing and planning for contracting with Payers in anticipation the change to ICD-10 in October 2013.
Health care payers will be designing their reimbursement plans for 141,000 new ICD10 codes. It will be critical for providers to know their required reimbursement for these new codes before they negotiate with Payers who will certainly try to reduce reimbursement.
In this adversarial healthcare environment, health care providers must be proactive in understanding a strategy to avert potential disasters in their reimbursement system. With the thin margins that most hospitals already operate on, we believe this will be one of the most important aspects of implementing ICD10. ICD-10 is not just a new diagnostic system of coding; it is more importantly a new reimbursement system.
Here are just a few more to think about:
Avoiding the ICD-10 implementation train wreck will be easier if your company is doing an assessment of the business, process, system, clinical and IT impacts early in this process. Conversely, those health insurance firms, hospitals, clinics, physician groups and other entities who are proactive in seeing an ICD-10 assessment as an avenue to improved revenue and cash flow will be better positioned strategically when the market shifts.
If you do not believe you have these skills in house, look to partner with a consulting team that has the process, people, methods and tools to successfully navigate this new reimbursement system.