By Nancy Hirschl, BS, CCS, AHIMA-Approved ICD-10 Trainer Vice President, HIM Services, Streamline Health, Inc. For healthcare providers, limiting regulatory and financial risk associated with coding and billing is a core component of organizational compliance. Risks to the mid-revenue cycle can appear in the forms of undercoding, where appropriate revenue is not captured and money [...]
More and more, healthcare is becoming a consumer-driven environment. Thanks to provisions found in the Affordable Care Act (ACA), the industry is shifting from volume-based to value-based models of reimbursement. And with the establishment of the health exchanges, patients are being given even more choices when it comes to selecting coverage that most suits their budget and needs. Additionally, websites offering ratings of facilities and individual physicians are giving healthcare a consumer feel to match other industries.
Recently, Health Management Technology hosted a roundtable discussion featuring David Fletcher, Streamline’s director of solution development, as part of the publication’s newly launched Exclusive Conference Call Series. Centered on Big Data Analytics, the conversation also featured Dr. Stephen Ober, chief medical officer of Emdeon, and Bimal Naik, chief client officer of CitiusTech.
Healthcare organizations have been working with large amounts of data for many years, and while the term big data is generating a buzz within the industry, the concept is far from new. Due to the rise in the prevalence and variety of healthcare IT systems put to use in hospitals, however, the sheer quantity of information being produced is reaching new heights.
Big data is not a new concept in healthcare analytics, but as we all know, collecting that information is only the first step. For organizations to derive true value out of their data, they need the ability to analyze it and make it actionable.
Experts from the Centers for Medicare & Medicaid Services (CMS) estimate ICD-10 will initially result in a decrease in cash flow and loss of revenue. Denial rates are expected to increase by 100 to 200 percent post-implementation—and healthcare organizations will likely feel the burn of declining payments for up to two years after the implementation.
The move to ICD-10 is one the biggest changes to hit the US healthcare system. Hospitals that carefully prepare for the change by planning six months to a year in advance; implementing solutions that will simplify coding, enable machine-readable documentation and facilitate data collection; and establishing training programs that include those systems will not only experience a smoother transition but also see a greater return on their investment.