Preserve the HIM workforce during the ICD-10 delay

With the ICD-10 transition date now at least 16 months away, we must think about the impact this has on the workforce that was hired or educated with the original date in mind
By
Bonnie Cassidy

The American Health Information Management Association (AHIMA) represents 74,000 members who have been preparing for ICD-10 for years.  With the transition date now at least 16 months away, we must think about the impact this has on the workforce that was hired or educated with the original date in mind. Across the U.S, ICD-10 transformation teams have been assessing, training and implementing technical changes that were to be in place on October 1, 2014.

 “This frustrates me. For the last 4 years of my career I have prepared for this transition, passed the AAPC ICD-10 Proficiency Assessment, and our government once again decides THEY aren’t ready. How am I supposed to convince my surgeons that they have to work on this when it keeps getting delayed?” certified coder/auditor

Hospitals and provider offices in the U.S. hired skilled HIM coding professionals to prepare for the transition to ICD-10.  Some were consultants, coders, and project managers while others supported revenue cycle and HIT initiatives. What are these organizations going to do now with these highly-skilled members of the workforce? There are concerns that smaller hospitals and health systems may be forced to have layoffs, while others may redirect these resources to Meaningful Use initiatives or stay the course while being champions for ‘No ICD-10 Delay’!

As a past president of AHIMA, I have been meeting daily with HIM colleagues across the country as they rethink their strategies for ICD-10 implementation. The ripple effect of this latest delay has been devastating for some, particularly new graduates. There are still so many refinements that must be addressed for ICD-9 and ICD-10 coding workflow redesign, that HIM resources are critical for the much needed fine tuning of clinical documentation to ensure the highest level of accuracy for both financial and clinical success – not to mention optimizing the use of new technologies tied to the current and future state of the healthcare coding system.

“We are going to find ways to use these employees we hired to do I-10 coding. There seems like there is so much need for documentation, classification and informatics in healthcare we will make sure to find use for these folks in the interim,” reports Todd Strumwasser, CEO of Swedish Seattle.

The Impact of the Delay on Resources

  • New grads and new hires – They expected their coding skills would be in high demand and now find that some of the anticipated vacant positions have vanished. This delay casts a cloud on the employment prospects of more than 25,000 students who have learned to code exclusively in ICD-10 in HIM associate and baccalaureate educational programs. We must ‘stay the course’ and hire these precious resources.
  • Physicians and practices – Some fell behind on their ICD-10 implementation and rejoiced at the delay news, but professional practices should use the time to prepare their clinical documentation for improved ICD-9 coding while they implement CDI programs.
  • Coding educators – Coding education programs and educators had switched to teaching only ICD-10 codes to students, but now are reevaluating their educational plans and transition timelines, and are putting ICD-9 back into the curriculum and certification exams because new graduates need both ICD-9 and ICD-10 to work.  This is a costly effort, as it requires re-training as well as redesigning coursework to appropriately prepare students.
  • Tax payers – CMS estimated that another one-year delay of ICD-10 would cost the industry an additional $1 – $6.6 billion on top of the costs already incurred. This does not include the lost opportunity costs of failing to move to a more modern and specific code set, which better supports population health and data analytics to identify optimum clinical treatments on different types of patients. Don’t kid yourself. We are all paying for the delay in some way.

The ICD-10 delay has been devastating to some and costly to all. My advice to healthcare executives and clinicians is do not stop your ICD-10 transition planning. Stay the course and use the time for testing and auditing so you will be prepared for success.

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  • njnordo

    Thank you, Bonnie. As a person who is going through a career change, with my education in pursuit of a B.S. in RHIA as my goal, I’m concerned, nervous and worried about pursuing a HIM degree. Your article alleviated some of my concerns and thank you for that.

Bonnie Cassidy

About Bonnie Cassidy

Bonnie Cassidy is the senior director of health information management (HIM) innovation for Nuance, where she oversees the development and implementation of HIM strategies. She currently serves on the Commission on Accreditation for Health Informatics and Information Management (CAHIIM) Board of Directors, is a Fellow of AHIMA, an AHIMA Academy ICD-10-CM/PCS Certificate Holder and ICD-10 Ambassador, and a Fellow of HIMSS. Prior to joining Nuance, Bonnie served as the vice president of HIM product management & innovation at QuadraMed, and served as an executive with the Certification Commission for Healthcare Information Technology (CCHIT), Ernst & Young and the Cleveland Clinic Foundation. She was the 2011 President/Chair of AHIMA. Bonnie received her graduate degree from Cleveland State University and her Bachelor’s Degree in HIM from Daemen College. Bonnie grew up in Buffalo, NY, lived in Cleveland, OH and has been a resident of Atlanta, GA for 17 years. She considers the Bills, the Browns and the Falcons her hometown teams.