Recent reports examining ICD-10 readiness have yielded conflicting results, and in many cases have found that industry groups are well aligned with the Centers for Medicare and Medicaid ICD-10 preparation timeline.
In one arena are the groups who have recently voiced readiness concerns, which include the Workgroup for Electronic Data Interchange, health IT adviser group to HHS.
WEDI has conducted ICD-10 readiness surveys since 2009, and its 2013 data suggests providers are trailing behind. Officials cited the more than 40 percent of providers that have not conducted impact assessments, implemented business changes or started external testing.
"Based on the survey results, it is clear the industry is not making the amount of progress that is needed for a smooth transition," wrote Devin Jopp, president and CEO of WEDI, in an April letter to HHS. "Factors that contributed to this slow progress include the change in compliance dates, competing internal priorities and other regulatory mandates."
An April study conducted by coding services company Health Revenue Assurance Associates echoed similar findings, concluding that the pace at which providers are moving toward the ICD-10 transition is lagging behind where it needs to be, with 20 percent of small- and mid-sized hospitals indicating they have yet to begin any education or training.
"The shift from ICD-9 to ICD-10 is equivalent to learning another language; it will not be as easy as flipping a switch," said Andrea Clark, chief executive officer of HRAA, in a press statement.
Of the 120 hospitals surveyed by HRAA:
• 40 percent have not started ICD-10 CM training for coding staff;
• CMS recommends this begin by January 2014.
• 55 percent have not started ICD-10-PCS training for coding staff;
• CMS recommends this start by January 2014.
• 47 percent have not started document improvement education for medical staff;
• CMS recommends this start by January 2014.
"This is a statement, and it's also startling," said Clark in an interview with Healthcare IT News. "That extension didn't help because that was six months loss in the timeline where many hospitals put on the brakes."
She pointed out that many organizations stopped their steering committees, education sessions and even reallocated ICD-10 budgets to other initiatives.
However, contrary to the vendor's verdict - which seems to suggest that providers still have some leeway - American Hospital Association data revealed 70 percent of hospitals assumed a more positive view toward the delay, seeing it as a breather that allows added time to get their house in order.
Before the October 2014 deadline was announced, 61 percent of all hospitals were either ready or under way and on track with ICD-10 implementation, according to a 2012 AHA survey.
Moreover, 25 percent of hospitals indicated they were at least under way with implementation, despite being behind. Now these hospitals have an extra year.
"Worst case, (the delay) just gives our folks in medical records a little bit more time to practice," said Barry Blumenfeld, then chief information officer of MaineHealth, in a fall interview with Healthcare IT News.
Although HRAA's survey finds that between 40 to 55 percent of small-to midsized hospitals have yet to initiate ICD-10 training for coding staff, AHA data suggests otherwise.
Overall, 77 percent of hospitals said they had already initiated training plans for coding staff.
• 84 percent of hospitals with <100 beds
• 68.5 percent of critical access hospitals
• 81 percent of hospitals with 100-299 beds
From the same data set, 89 percent of hospitals indicated they were confident or very confident they would be ready for the original ICD-10 deadline.
George Arges, senior director for health data at AHA, said the association is in the process of collecting 2013 data, but even today these numbers are a good reflection of hospital readiness.
"From what we are hearing from our members, many of them are making good progress toward being ready," said Arges, senior director for health data at AHA.
He explained that providers who have expressed concern have been the smaller hospitals.
However, more and more of those providers are saying they'll be good to go come the 2014 deadline. They have to be.
Ralph Johnson is one of them. "We'll be ready," said the chief information officer of the 65-bed Franklin Community Health Network in rural Maine. "From a technology point of view, the fewer systems you have the easier this is to do."
Johnson's not without concerns, however. He's more worried about training his staff than the systems or technology and fears the payers are far from where they need to be. "(Payers and providers) are going to be living in two worlds," he added.