Will ICD-10 Be Healthcare’s Own Version of the Fiscal Cliff?

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With the nation focused on the looming fiscal cliff, it may be a good time to evaluate ICD-10’s financial impact on healthcare providers. In a recent post, Jvion examines the fiscal risks associated with ICD-10 and provides the steps necessary for providers to prepare for and avoid its negative impacts.

Providers can expect to see a 2-6% drop in revenues depending their type of business and case mix

While the shift to ICD-10 pales in comparison and reach to the looming fiscal cliff faced by the nation, it does pose a financial risk to providers who stand to lose millions because of the code conversion. “Providers can expect to see a 2-6% drop in revenues depending their type of business and case mix,” explained Surya Vadlamani, Jvion CIO and chief ICD-10 solution architect. “As providers develop their ICD-10 roadmap and prepare their conversion plans, there is a recognition that the shift will not be as ‘revenue-neutral’ as once thought. Organizations are acutely aware of the reimbursement variations that ICD-10 will cause and are looking for ways to avoid dips in revenues following October 2014.”

Many providers are taking a renewed, revenue-focused approach to ICD-10 to help address reimbursement risks. This tactic puts reimbursement variations at the heart of the conversion and prioritizes all activities by financial impact. According to Jvion, there are six major components to becoming revenue-focused:

  •     Business involvement: key stakeholders from finance and high risk areas need to be integrated into the conversion and ICD-10 steering committee
  •     Leadership support: leaders must be aligned around ICD-10’s financial impact and have a sense of ownership for mitigating that risk
  •     Strategy: ICD-10’s financial impact should be at the foundation of an organization’s overall ICD-10 strategy
  •     Performance measures: an organization must have analytics that baseline ICD-10’s revenue risk and provide a means for measuring the effectiveness of conversion activities designed to reduce that risk
  •     Prioritization enablement: recognizing that providers do not operate on endless funds and resources, all conversion activities must be prioritized by financial risk
  •     Vendor: all third party vendors must have a way of reporting on ICD-10’s financial and operational impacts during testing and post conversion

Surya went on to explain that, “providers can operationalize a revenue-focused approach through a granular, ICD-10 financial risk assessment.” These assessments provide the outputs needed to determine which actions a provider should take across the conversion to avoid negative reimbursement shifts and volatile revenue fluctuations.

For more information on Jvion’s ICD-10 financial risk assessment solution and how it can help providers prepare for and avoid negative reimbursement impacts, please visit http://www.jvion.com/revcore.html.

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 http://www.jvion.com for more information.


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Allison Alavi
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