Jvion Provides Perspectives on Addressing ICD-10 Financial Risk

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In a recent article co-authored with the HIMSS ICD-10 PlayBook, Jvion explains the benefits, challenges, and next steps in taking a revenue-focused approach to ICD-10.

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With (financial risk) information, (providers) can identify the departments, specialties, coders, and even physicians who have the potential to negatively impact reimbursements following the implementation of ICD-10-CM and -PCS

Jvion—a leader in assessing and addressing ICD-10 financial risk—recently co-authored an article with the HIMSS ICD-10 PlayBook that examines the impacts and benefits of taking a revenue-focused approach to ICD-10. With increased interest from CFOs in ICD-10, there is a push for detailed visibility into potential negative reimbursement risks. As a result, providers are looking to take the next step in financial risk assessments through a historical claims analysis that allows providers to prioritize remediation efforts on avoidable negative impacts. A copy of the article is provided below.

“Much has been written about CMS’s claim that ICD-10 will have a neutral impact on revenues. However, it is no secret most analysts and experts within the HIM community disagree with the statement or concept of revenue neutrality. Providers are beginning to take a hard look at revenue impacts hidden within the ICD-10 conversion and what they will mean for healthcare in the short and long-term.

‘Industry wide, organizations are starting to analyze the impact that ICD-10 will have post conversion,’ commented Dwan Thomas Flowers, ICD-10 Task Force Chair. ‘To date many providers have taken revenue impacts at face value. That is, they either assumed that revenue neutrality can be achieved through current crosswalks or they assumed a high-level percentage impact based on general industry trends.’

With new self-assessment tools like the HIMSS ICD-10 PlayBook Financial Risk Calculator and a renewed focus on ICD-10, providers are taking the first step toward answering the question, ‘What is the exact percentage impact that ICD-10 will have on my revenues?’ Most are finding the solution lies in taking a revenue-focused approach to ICD-10 that examines operational cost, cash flow, and revenue risks.

Becoming revenue-focused can be hard. Shantanu Nigam, ICD-10 Task Force member and Jvion CEO, explained that, ‘Many providers, especially large systems, have already completed their ICD-10 assessments. They have invested time and money in roadmaps and plans that—while comprehensive—are not necessarily prioritized by financial impact and magnitude of risk. To move forward in a revenue-focused way, these organizations will have to revisit the work performed during the assessment phase, and take a closer look at the precise operational and financial risks posed by ICD-10.’

Providers who are taking a revenue-focused approach want a way to get to ICD-10’s exact percentage impact in terms of actual dollars. Many are looking to perform a detailed historical claims analysis that provides insight into which codes pose the highest risk to revenues. With this information, they can identify the departments, specialties, coders, and even physicians who have the potential to negatively impact reimbursements following the implementation of ICD-10-CM and -PCS. Shantanu went on to say that, ‘A historical claims analysis is really the next step in understanding ICD-10’s financial impact in that it helps providers focus remediation on avoidable negative impacts.’

As organizations seek ways to address ICD-10, understanding the new code sets’ exact percentage revenue impact is certain to become a focal point. The good news is it is not too late to take a revenue-focused approach. Providers can start by looking to the HIMSS ICD-10 PlayBook for resources and self-assessment tools like the ICD-10 Financial Risk Calculator. With market maturity, more service providers are likely to offer the kind of financial risk assessments and software-enabled historical claims analyses that deliver detailed revenue impacts. Additionally, as the industry as a whole gains a better understanding of ICD-10’s revenue risks, there will be more opportunities to see actual benefits from use of the code sets.

For more information about the ICD-10 Financial Risk Calculator and other ICD-10 resources, please visit http://www.himss.org/ASP/topics_icd10playbook.asp.”

For more information on Jvion’s RevCore Financial Risk Assessment solution and how to identify ICD-10 revenue impacts at the code, DRG, MDC, specialty/department, facility, and even coder and physician levels please visit http://www.jvion.com.

About Jvion
Jvion is a privately held 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.

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Allison Alavi
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