Less than 10% of practices reported that they had made significant progress when rating their overall readiness for ICD-10 implementation by the Oct. 1 due date, up only slightly from 4.7% since June 2013, according to a survey by MGMA.
MGMA research includes responses from more than 570 medical groups where more than 21,000 physicians practice.
“The critical coordination that must take place between practices and their software vendor, clearinghouse and health plan partners is simply not happening at the pace required for a seamless implementation. Very simply, ICD-10 is behind schedule,” said Susan L. Turney, MD, MS, FACP, MGMA president and chief executive officer.
MGMA urged the Centers for Medicare & Medicaid Services (CMS) to immediately take action to help ensure that physician practices can successfully undertake such a massive transition, including:
• Initiating complete end-to-end testing with physician practices assessing claims throughout the entire business cycle
• Releasing all Medicare and Medicaid payment edits and advising commercial health plans to do the same
• Publishing on an ongoing basis the readiness level of all Medicare contractors and state Medicaid agencies
• Assessing the readiness and targeting outreach to practice management and electronic health record (EHR) software vendors serving physician practices
• Continuing to expand provider education efforts, especially to smaller and more vulnerable organizations
MGMA research also revealed:
Software upgrades or replacements are needed. More than 80% of respondents indicated that their practice management software would require replacement or upgrading in order to accommodate ICD-10 diagnosis codes, up from 73.2% in June. Moreover, 81.8% indicate that their EHR needs to be replaced or upgraded, a jump from 65.3% in June.
Significant software costs to be absorbed by practices. Just 41% of respondents reported that their cost to upgrade or replace their practice managementsystem software will be covered by their vendor, with about 50% of respondents indicating that their vendor will cover the cost of their EHR replacement or upgrade. For those required to cover these software costs, they report an average cost of $11,500 per full-time equivalent physician for the practice management upgrade or replacement and $12,885 for the EHR. This translates into a cost of $243,850 for a 10-physician practice for the ICD-10 software alone.
Internal software testing lagging. Only 8.2% stated that they have begun or completed testing with their EHR vendor, compared to 4.7% in June. Slightly more than 10% of respondents reported that internal software testing had begun or is complete with their practice management vendor, a slight increase from 5.9% in June.
External communication and testing delayed. In June, 70% of respondents stated they had not heard from their major health plans regarding the date on which ICD-10 testing would begin. Six months later, nearly 60% say they still have not heard from their health plans. Moreover, only 5.4% reported that they have begun testing with their major health plans. Almost 60% stated in June that they had not heard from their clearinghouse regarding a testing date, and nearly 50% indicate they still have not heard. Only 8.1% reported that they had started testing with their clearinghouse.
Concern about clinical documentation and loss of productivity remained constant. The number of respondents who indicated that they are concerned or very concerned about the expected changes to clinical documentation remained constant at about 89%. Similarly, about 89% reported in both January and June that they were concerned or very concerned about the loss of clinician productivity after implementation, and about 86% about the loss of coding staff productivity. Finally, the expected change in difficulty for clinicians to select appropriate diagnosis codes remains extremely high with nearly 98% expecting that it will be somewhat or much more difficult under ICD-10.
MGMA offers members resources available to help them through the transition.
MGMA In Practice blog: 3 provider documentation misconceptions
ICD-10 Preparation Guide
ICD-10 Virtual Academy
ICD-10 Implementation Guide for Physician Practices
10 questions to help you prepare for ICD-10
ACP also offers resources at its Running a Practice section of its website.