Hometown Health Spring Conference

1. Hometown Health Spring Conference Dr. Denise W. Hines, PMP, FHIMSS GA HIMSS Chapter President GA-HITREC-Director of Education & Outreach

2. Overview • HIMSS/GA HIMSS • ICD-10 • GA-HITREC Education Opportunities • Meaningful Use Stage 2 & Stage 3 • Questions

3. HIMSS • Health Information Management & Systems Society • Over 44,000 members nationally • Dedicated to the use of health information technology to improve healthcare • Founded in GA at GA Tech

4. GA HIMSSMission and Vision Collaborate Signature Events HIMSS National Events (Advocacy & National Conference-GA Chapter Events) Georgia Healthcare Trade Faire & Regional Conference Lunch & Learns Meet the Board Events Golf Tournament CPHIMS Review & Exam Nursing Informatics Conference Student Scholarships & Involvement Educate Advocate www.himss.org www.gahimss.org

5. ICD-9 to ICD-10 • ICD-9 is 30 years old, outdated and obsolete, inconsistent with current medical practice • Covered entities must move from using ICD-9 to ICD-10 to submit claims on and after the compliance date • For hospital inpatient only, does not affect CPT codes (outpatient) • Different structures: • ICD-9 is mostly numeric with 3 to 5 digits. • ICD-10 is alphanumeric with 3 to 7 characters. Contains “one to many” matches • ICD-10 must be done to issue claims and to get paid • Original date for compliance was Oct. 1, 2013 to Oct. 1, 2014

6. Benefits of ICD-10 • More accurate payment for procedures • Fewer improper and rejected claims • Better understanding of health conditions • Better monitoring and reporting of disease from a public health perspective

7. Examples of Changes ICD-9 ICD-10 Diabetes Mellitus 200 Codes Injuries 7th character extension Fracture of the femur, shaft, closed -24 codes Pathologic Fracture 150+codes • Diabetes Mellitus • 59 Codes • Injuries • Fracture of the femur, shaft, closed • 1 code • Pathologic Fracture • 8 codes

8. ICD-10 Readiness and Costs • HHS cites a CMS survey finding that one quarter of providers do not believe they will be ready by October 1, 2013, and a recent WEDI readiness survey in which nearly 50 percent of the 2,140 providers responding did not know when they would complete their impact assessment. • HHS projects that ICD-10 will cost commercial and government health organizations between $650 million and $1.3 billion.

9. Costs to Delay Compliance to 2014 Savings would come from the avoidance of costs that would occur as a consequence of significant numbers of providers being unprepared for the transition to ICD-10. HHS determined a cost avoidance of between $3.6 billion and $8 billion – but acknowledged that “a 1-year delay of the ICD-10 compliance date would add 10 to 30 percent to the total cost that these entities have already spent or budgeted for the transition.” HHS demonstrated that a 1-year delay in the compliance date of ICD-10 would cost the entire health care industry approximately $1 billion to $6.5 billion.

10. Reactions to the Delay (10/1/13 to 10/1/14) • American Medical Association-Applauded the delay • College of Health Information Management Executives-(CHIME)-Appreciates the extra breathing room but doesn’t want to lose focus. • Medical Group Management Association (MGMA)-wants ICD-10 certification of practice management system vendors. • American Hospital Association-"welcome news, particularly for smaller hospitals.” • American Health Information Management Association (AHIMA)-preferred no extension and supports the shortest extension period; continued delay is in no one’s best interest .

11. ICD-10 Project Management Steps • Designate a Project Manager & Team • Review the impact to the organization • Develop Work Plans • Health Information Management • Clinical Departments • Information Technology/Systems • Revenue Cycle/Finance • Application Assessment & Readiness • Physician and Staff Training

12. Project Management Tips • Gain buy-In from Administration/Executive Team • Identify a physician champion • Use a Steering Committee • Provide On-going education about the importance of the project and the status • Offer a variety of training methods and tools: • One-on-one • Off-site training sessions • Rounding • Departmental/Medical Staff Meeting

13. Summary/Take-Away Points • Transitioning from ICD-9 to ICD-10 will be challenging • Requires more complete and accurate documentation by physicians • Thorough knowledge of anatomy and physiology by nurses, clinical staff, and coders • Benefits include more complete patient information (severity of illness, medical necessity) and improved reimbursement • Don’t be afraid to ask for help! • Prepare for ICD-11

14. Stages of Meaningful Use Meaningful Use Stage 1 Effective until 2014 • Providers can receive 3 payments under Stage 1 • 2011, 2012, 2013 ($18K, $12K, $8K) Meaningful Use Stage 2 NPRM released • Delayed to allow vendors time to implement new functionality • Offer your feedback (60 day comment period beginning 3/17) • Final should be ready by Summer • Builds on stage 1 with increased thresholds • Exchange of information required • Electronic access for patients • Updates to quality measures

15. Stages of Meaningful Use Meaningful Use Stage 3 • Ready by 2015 and required by 2016 • Builds upon Stages 1 and 2 with increased thresholds • Enhanced bi-directional exchange with public health agencies: • Immunization, lab, and syndromic surveillance data • Demonstrate improvement in patient outcomes • Patient access to self management tools, upload data

16. GA-HITREC Online Education ONC Workforce Curriculum Available: • ONC Component 1: Introduction to Health Care and Public Health in the U.S. • ONC Component 3: Terminology in Health Care and Public Health Settings • ONC Component 8: Installation and Maintenance of Health IT Systems WEBINARS: • Patient Engagement Strategies • Medicare/Medicaid Attestation • Meaningful Use and Value Based Purchasing • Using Patient Data to Improve Health Outcome • The Secure Exchange of Health Information • Planning, Management, Leading for Health IT • Health Information Management Systems – Coding • ICD-10

17. Resources GA-HITREC 877-658-1990 www.ga-hitrec.org CMS Incentive Programs www.cms.gov/ehrincentiveprograms GA Medicaid Incentive Program www.dch.georgia.gov/ehr GA HIE Email: hitt@dch.ga.gov Stage 2 NPRM http://www.healthit.gov/providers-professionals/meaningful-use-stage-2 ICD-10 Resources www.cms.gov/ICD10

18. QUESTIONS ????