Buying In—Using ICD-10 Financial Risk Assessments to Drive Engagement

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ICD-10 Financial Risk Assessments have grown in sophistication and number over the past months. In addition to pin pointing ICD-10 revenue impacts, these assessments are proving to be an effective change management tool across multiple levels within an organization. In a recent perspective, Jvion demonstrates the link between analytics and the effectiveness of change efforts supporting ICD-10 initiatives.

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With the availability of more encounter-based assessments, change management activities can be tied directly to (ICD-10) financial risk

With the increased popularity and use of ICD-10 financial risk assessments, providers are looking for ways to expand the applicability of their outputs. Most financial risk assessments provide insights into DRG-level financial shifts and the resulting potential revenue impacts within a facility. From this data, organizations can extrapolate the documentation, training, and remediation activities that will mitigate losses and optimize gains at a high level. There are, however, more advanced techniques in financial risk assessments that go beyond DRG shifts to pin point the specific departments, coders, and physicians that pose the highest risk to revenues. These more granular approaches, or encounter-based assessments, can be easily translated into effective change management activities that drive engagement across an organization.

Often times change management is fuzzy—it isn’t easily translated into measureable actions, it isn’t tied to specific hard numbers, and it is often reduced to organizational-level communications.

With the availability of more encounter-based assessments, change management activities can be tied directly to financial risk that can then be applied across five broad categories:

  •     Training—by understanding the specific individuals associated with high risk and high opportunity codes, an organization can build a detailed training plan that enables tailored curriculums based on revenue shifts. This kind of individual-level information accelerates the training planning timeline and results in a more effective training plan that enables higher levels of retention
  •     Physician engagement—encounter-level information means that an organization can see the physicians associated with reimbursement impacts. This information helps physicians understand ICD-10’s impact and provides a platform for physician involvement in developing the mitigating steps that will effectively reduce risk and optimize gains
  •     Communications—change management approaches often include something called a stakeholder map. This map—at a high level—is simply a charting of the groups of individuals impacted by a change plotted by how impacted they are and by how much risk they pose to the success of a project. Communications are typically prioritized and tailored to groups based on this map. With encounter-level financial risk assessment solutions, these stakeholder maps become much more precise and metrics driven. This means that communications that are based on the outputs of an encounter-level financial risk assessment are better tailored and more effective at mitigating potential financial losses and increasing the overall effectiveness of an organization’s ICD-10 initiative
  •     Leadership engagement and alignment—understanding the individuals, specialties, and ultimately departments associated with high revenue shifts means that you have clear visibility into the leaders who not only need to engage in ICD-10 activities, but who also need to be aligned to mitigate potential losses. And by having dollar figures associated to each leader, an organization can drive better accountability and transparency into performance during dual coding, testing, and after go live

As ICD-10 financial risk assessments continue to mature, we should see change management approaches and techniques develop as well. And as the industry moves through the conversion process, the outputs of financial risk assessments will most likely be used as a monitoring device, not only for remediation activities, but also for adoption and retention. Having access to ICD-10 financial risk assessment data gives change management something that is often hard to find—a quantifiable, defined, and financially focused platform driving all activities and measures of success.

About Jvion
Jvion is a healthcare compliance technology and services organization with a full suite of tools to enable the ICD-10 conversion. The company serves providers and payers in all phases of the ICD-10 conversion process with a simple value proposition—by using Jvion’s tools and solutions, organizations can do more to reduce cost, mitigate risk, and optimize reimbursements with fewer resources and in a shorter time line. Please visit Jvion’s website at for more information.


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Allison Alavi
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