Study: A Delay of the ICD-10 Compliance Deadline Would Increase Costs and Not Improve Readiness

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Edifecs Stands With Leading Industry Groups and Encourages Healthcare Organizations to Continue Planning For and Implementing ICD-10

Edifecs, Inc. today released the results of a survey about the impact a postponement of the ICD-10 compliance deadline would have on a healthcare organization’s ICD-10 transition plans, budget and progress. The survey is one of the first to evaluate industry reaction to the U.S. Department of Health & Human Services’ (HHS) announcement that it would consider delaying the ICD-10 implementation deadline for certain entities. Less than 48 hours after HHS’ announcement, the survey was conducted among more than 50 senior healthcare professionals attending the 2012 ICD-10 Summit, a conference hosted by Edifecs, a leading provider of healthcare software solutions. Among the findings are indications that nearly two-thirds of respondents (64 percent) believe a delay will not improve readiness, 76 percent believe a delay will harm other healthcare reform efforts, and 69 percent say a two-year delay would be either “potentially catastrophic” or “unrecoverable.”

“The message we heard loud and clear from conference attendees and survey respondents was to keep moving while the industry awaits the final decision on the extended deadline and which entities will be affected,” said Sunny Singh, CEO of Edifecs. “The survey results tell us that stopping or slowing down work is a very real outcome of a delay, and it could derail a healthcare organization’s progress. The cost implications alone are worrisome.”

ICD-10 is a major investment for payers and providers alike. When asked what percentage cost impact a one-year delay would have, nearly half of respondents said it would increase costs between 11 and 25 percent, and another 37 percent of respondents said the cost would be up to 50 percent. Edifecs estimates the cost of a one-year delay to be between 25 to 30 percent. Based on existing overall cost estimates for ICD-10 from multiple sources (1), a year-long delay in ICD-10 could therefore cost the industry anywhere from $475 million to more than $4 billion.

Other findings from the survey include:

  • Nearly two-thirds of respondents (64 percent) said a delay would not result in improved readiness – rather, organizations will slow down implementation so the resources (budget and personnel) can be redeployed to other, more urgent initiatives. This is in comparison to 36 percent who said a delay would improve readiness – one potential benefit of a delay is more time for testing, but that assumes projects will not be slowed or stalled.
  • When asked what the preferred time frame would be for a delayed compliance date, an astounding 85 percent of respondents believe a shift in the compliance date should not exceed one year. A delay of longer than a year will likely freeze budgets, slow down schedules or stop work altogether.
  • More than half of respondents (59 percent) believe the date should be moved out for all covered entities, versus mandating different compliance dates for different types of entities. The main driver behind the overwhelming preference for a single compliance deadline for all entities appears to be the significant cost and effort needed to run in the dual processing in ICD-9 and ICD-10 code sets for the same dates of service.

To review the survey and full analysis of the findings visit:

(1) U.S. Department of Health and Human Services. Federal Register, Vol. 74, No. 11. HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards To Adopt ICD–10–CM and ICD–10–PCS. January 16, 2009.
(1) America’s Health Insurance Plans, Center for Policy and Research. Health Plans’ Estimated Costs of Implementing ICD-10 Diagnosis Coding. September 2010.
(1) Nachimson Advisors, LLC. The Impact of Implementing ICD‐10 on Physician Practices and Clinical Laboratories. October 8, 2008.

About the Survey: The Healthcare Industry’s Reaction to Potential Delay of ICD-10
The survey was conducted on February 17, 2012 among healthcare payer and provider attendees of the 2012 ICD-10 Summit, an industry conference hosted by Edifecs that took place February 15-17, 2012 in Cape Coral, Florida. Summit attendees represented a wide range of healthcare organizations, including commercial payers (25%), Blue Cross Blue Shield plans (25%), healthcare providers (18%), government entities such as State Medicaids (9%), medical claim clearinghouses (6%), and other healthcare industry organizations (17%). The results represent the voluntary and anonymous responses from more than 50 senior healthcare professionals—all of whom are actively involved in their organization’s ICD-10 transition and carry significant responsibility for the overall success of the project. Forty-nine percent of attendees’ ICD-10 efforts are currently in the development phase, while 36 percent are in the planning phase. Ten percent are implementing, and five percent are in testing.

About Edifecs, Inc.
An industry leader since 1996, Edifecs provides healthcare software solutions that improve operational performance by streamlining the exchange of information among health plans, hospitals, and other healthcare organizations, while enabling compliance with current mandates such as HIPAA 5010 and ICD-10.

Today, more than 250 healthcare customers use Edifecs technology to unify transactions from any information channel source and input mechanism, while automating manual business processes such as enrollment, claims and payments management.

Edifecs is currently recognized as one of the 100 Fastest Growing Private Companies in the state of Washington, 100 Best Places to Work in the state of Washington, an Inc. 5000 fastest-growing private company and one of the 500 Fastest Growing Companies in North America by Deloitte. Edifecs is headquartered in Bellevue, WA. For more information, please visit

Contact Michael Thomas of Raffetto Herman Strategic Communications, PR firm for Edifecs at mthomas(at)rhstrategic(dot)com.


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Robin Rees
Edifecs, Inc.
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Michael Ann Thomas
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