by Carl Natale
Posted on Tue, Jun 19, 2012 - 11:12 am
I can sympathize with the American Medical Association (AMA) when it talks about how complicated ICD-10 implementation will be. After all, this blog is home to plenty of posts warning of an impending Codapocalypse.
The stakes are high if healthcare providers don't get it right.
But ICD-10 implementation is looking like a walk in the park compared to what else is coming.
"The majority of organizations we're talking to is looking to do a business transformation," says Ray Desrochers, executive vice president of sales and marketing at HealthEdge. And those organizations are healthcare payers who are using the ICD-10 transition to upgrade their systems and business models. "Many, many organizations are reinventing themselves all the way from the core business processes to the technology to even the people - how they train their people in their organizations."
"ICD-10 is but one of many things going on in healthcare right now. It's but one of many changes that they will have to react and respond to if they are going to successful in this new healthcare economy," says Desrochers.
He's talking about "value-based health plans where we link and motivate the member to do the right thing." And "pay for performance and ACO initiatives and pay for performance initiatives where we motivate the provider to do the right thing."
That sounds a lot like accountable care organizations (ACOs). But Desrochers says that healthcare payers recognize that there are possibilities that haven't been considered yet. So upgrading systems for ICD-10 compliance is a chance to be ready for whatever comes next.
And that's a pretty scary thought. Major changes are coming that no one is seeing. Complicated doesn't even begin to describe it.
"For an organization that spends all it's time, energy and money going through an ICD-10 remediation and finds themselves with that problem solved, but unable to address all these other healthcare business needs -including the move to open exchanges, and ACOs and value based healthcare pay for performance - I think they're screwed," says Desrochers. "Because at the end of the day they will have missed the big picture."