Five Crucial First Steps for a Successful ICD-10 Journey

We are quickly approaching the ICD-10 implementation deadline and most payers and providers are still in the planning phase. A recent HIMSS ICD-10/5010 Readiness Survey shows that while providers are making significant progress on ICD-10, it is generally at a slower pace than that for HIPAA 5010.

With less than 30 months left until the compliance date (October 1, 2013), healthcare entities will have to start taking stock, assessing their readiness and taking control of their planning activities.

Because the impacts of ICD-10 are widespread within and beyond individual organizations, it is very important to focus on these crucial first steps before embarking on the exciting journey of ICD10 implementation:

1. Assessment – Identifying business and IT impacts will help define the scope of resources, effort, and distribution needed to help with remediation
2. Project Governance – Identifying key stakeholders and establishing the project governance early on will help employees prioritize their responsibilities and focus
3. Define ROI – Defining Return on Investment (ROI) is crucial for the success of any initiative. Monetary gains, process simplification, and client response and satisfaction are some of the key metrics that help define ROI. ROI is one of the most important aspects of ICD-10 implementation that must be presented to the internal stakeholders. Showcasing the potential ROI from an ICD-10 implementation will ensure executive support and sponsorship of the migration process.
4. Provider Contracting – Analysis of existing contracts, claim analysis and claim adjudication will provide necessary information and serve as input for ICD-10 financial modeling tools. These modeling solutions will in turn help payers and providers re-negotiate contracts and improve provider satisfaction
5. Utilization Management – A review of existing ICD-9 Utilization Data will provide inputs to ICD-10 predictive modeling and help payers design programs focused on member health

These are some of the basic steps that need to be taken before ICD-10 implementation activities can be initiated. As outlined in one of our earlier blog posts, it is important that everyone understands the magnitude of the upcoming migration, both in terms of the process and the end results. This will ensure everyone is on the same page and will make for a quicker and smoother transition.

Have you started your ICD-10 Implementation process? What crucial first steps did you take? We’d love to hear your thoughts.