What s Up Wednesday Together Let s Get ICD-10 Ready Date: August 21, 2013 Time: 2pm 3pm Phone Number: 1-800-882-3610 Pass Code: 5411307 Presented by the Pennsylvania Blues Plans
Today s Agenda Introduction o What is What s up Wednesday? PA Blues Plans and ICD-10 o ICD-10 readiness survey results The Hospital & Healthsystem Association of Pennsylvania o ICD-10 survey results Thoughts and questions o What would you like to talk about next? 1
Who is Speaking Today? Overview of What s up Wednesday series o Deb Cotter o Director, Strategic Programs Highmark Blue Shield ICD-10 Readiness Survey o Kathleen Grabowski o Program Manager, ICD-10 Implementation - Capital BlueCross The Hospital & Healthsystem Association of Pennsylvania o Martin Ciccocioppo o Vice President, Research 2
What s Up Wednesday Increase collaboration, communication and education. Expand understanding of ICD-10. Raise awareness of unique challenges. Share tools, techniques and best practices. All call attendees are on mute except for any guest speakers and all panelists. If you have a question, please e-mail it to ICD10ProviderCommunication@capbluecross.com so we can address it during the call. 3
The PA Blues Plans: How we are working together
Pennsylvania Blues ICD-10 Collaborative Four Pennsylvania Blues plans Capital BlueCross Highmark Blue Shield Independence BlueCross BlueCross of Northeastern PA Current priorities Providers and Facilities Surveys Collaboration with Statewide Trade Associations 4
Survey Results: ICD-10 Readiness of Pennsylvania s Physician Community
Survey Results Overall Summary 589 surveys completed 111 surveys were counted as incomplete due to limited answers The majority of the participants were small professional offices Practice size of 1-5 physicians 46% of participants rely on vendor software to select ICD codes Many surveyed have little or no awareness of the federal mandate 5
Survey Results Key Points 50% of participants have not started any planning for ICD-10 Most participants will start to plan 3rd quarter 2013 Participants will start training 1st quarter 2014 42% of participants have not dedicated resources to ICD-10 Lack of overall knowledge about ICD-10 is concerning Impacts on IT, finance and staffing, if compliance date not met 6
What type of provider do you represent? 450 400 350 300 250 200 150 100 50 0 Behavioral Health Clinic/Health Center Hospital Physician's Office Incomplete Surveys Physician s Offices = 403 completed surveys Hospitals = 42 completed surveys Clinical/Health Center = 18 completed surveys Behavioral Health = 15 completed surveys 7
What is your practice size? 45 40 35 30 25 20 15 10 5 0 1-5 practitioners 6-20 practitioners 21 practitioners or more 55% of the participants fall into the category of a small sized providers office (as defined by CMS: 1-5 physicians per office) 24% are defined as a medium sized provider office 21% are defined as a large sized provider office 8
What resources do you currently use when selecting ICD codes and/or descriptions? 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Vendor software Coding books Online resources Miscellaneous Vendor software(46%) and Coding Books (34%) are noted as the tools of preference by the participants Online resources lags behind at 18% NOTE: Participants could check all that applied on this question 9
Which of the following resources, if any, is your organization likely to use to learn more about ICD-10? External website CMS website Health plan or vendor website Internal Training Consulting service Pennsylvania Medical Society HAP Unknown Misc 0 50 100 150 200 250 300 Despite the use of the internet, health plan/vendor websites, the CMS website is the leader in awareness and communication There is a large group of physicians who have yet to identify their preferred reference source NOTE: Participants could check all that applied on this question 10
How much of the planning process has your organization completed? 100 90 80 70 60 50 40 30 20 10 Less than 25% 25%-50% 51%-75% More than 75% but less than 100% We have completed the planning process entirely 0 44% of the participants have very little ICD-10 planning done Only 28% are at the half way or better mark of planning 1% - 8% overall have completed or are close to completing ICD-10 planning 11
What barriers does your organization face in its ICD-10 planning and implementation work? 1% 10% 3% 16% 15% 17% 22% 16% Significant financial impacts Significant IT impacts Staffing and training capacity Competing priorities Lack of knowledge Vendor/Trading partner readiness Lack of executive sponsorship Miscellaneous NOTE: Participants could check all that applied on this question 12
ICD-10 Transition AHA Quick Response Survey
Survey Results Overall Summary This was a Quick Response Survey The majority of the participants were hospitals High confidence rate that hospitals will meet the 10/01/14 compliance date External testing is noted as key priority with the hospitals 13
Survey Results Key Points There are competing priorities to ICD-10 The majority of the Hospitals are working with staff physicians on ICD-10 Education Supporting Documentation Over half of the hospitals have developed an implementation plan as well secured a budget Overall testing is planned for 3 rd and 4 th quarter 2013 There are 3 main areas of concern Testing with health plans, Medicare programs/contractors and Medicare contractors Vendor upgrades and coding staff resources Capital resources 14
Activities Hospitals Need to Complete in Preparation for ICD-10 Transition by October 1, 2014 15 Source: AHA Quick Response Survey, Results for Pennsylvania hospitals, June 2013
Activities Hospitals Need to Complete in Preparation for ICD-10 Transition by October 1, 2014 16 Source: AHA Quick Response Survey, Results for Pennsylvania hospitals, June 2013
As the hospital prepares for external testing, will you develop a list of mission critical components? % responding Yes If YES: 17 Source: AHA Quick Response Survey, Results for Pennsylvania hospitals, June 2013
Is the hospital engaging with staff physicians in ICD-10 implementation? Activities that hospitals are undertaking with staff physicians: If YES: % responding Yes Source: AHA Quick Response Survey, Results for Pennsylvania hospitals, June 2013 18
Ranking of Competing Priorities Hospitals are facing competing priorities. They were asked to select their top three priorities (from the choices below) that are making the transition to ICD-10 tougher. Competing Priorities: Identified as PRIORITY #1 Identified as PRIORITY #2 Identified as PRIORITY #3 Meeting MU Requirements 45.0% 43.3% 11.7% Expanding Patient Care 29.6% 25.9% 44.4% Quality Reporting 12.8% 34.0% 53.2% Prior Capital Commitments 27.8% 33.3% 38.9% 19 Source: AHA Quick Response Survey, Results for Pennsylvania hospitals, June 2013
Next What s Up Wednesday Call Next What s Up Wednesday Call: o Scheduled for 09/18/13 2:00pm 3:00pm Visit a PA Blue s Plan website for more information: o Capital BlueCross https://cbc ICD-10 ToolKit o Blue Cross Northeastern PA https://www.bcnepa.com/privacy/hipaa/icd-10.aspx o Independence Blue Cross http://www.ibx.com/providers/claims_and_billing/icd-10.html o Highmark Blue Shield https://prc.highmark.com/rscprc/hbs/pub?document=https%3a//www.highmarkblueshield.com/health/documents/prof-pub/icd10-library.html We would like to hear from you so please send your feedback to ICD10ProviderCommunication@capbluecross.com 20
Follow-up If you have a question, please e-mail it to ICD10ProviderCommunication@capbluecross.com so we can address it during the call. Please feel free to reach out to a Blues Plan for more information o Capital BlueCross: ICD10PC@CapBlueCross.com o Highmark Blue Shield:ICD10Inquiries@highmark.com o Independence BlueCross: icd10@ibx.com o BCNEPA: Kevin.Quaglia@bcnepa.com 21
Questions