Doc practices concerned about cost, burden of ICD-10 rollout, survey shows

A new survey of more than 1,000 office-based physician practices expressed widespread and significant concern about the cost and the workflow burden perceived to be coming their way from the planned, nationwide rollout of the ICD-10 diagnostic and procedural codes.

More than 55% of respondents from 1,200 office-based practices surveyed by the MGMA-ACPME indicated they were “very concerned” about the overall cost of converting to ICD-10, which is scheduled by federal rule to launch Oct. 1, 2014.

Roughly 70% of respondents surveyed were very concerned about expected loss of clinician productivity, and the same percentage were very concerned about changes to clinical documentation, while better than two-thirds (67%) were very concern about loss of coder productivity.

About 71% surveyed responded that, to accommodate ICD-10, their electronic health-record systems either were upgraded or still need to be upgraded, will need to be replaced, or they are unsure which.

Practices estimated that it will cost about $10,000 per physician to upgrade or replace their EHRs to use ICD-10 codes, with 60% indicating their systems still need to be upgraded and only half reporting they'd heard from their vendor when that upgrade will be available. A little more than a third (37%) of practices said the cost to upgrade would be met by their EHR vendor. An equal percentage reported they'd have to pay for the upgrade themselves while another 24% were unsure.

Virtually none of the survey respondents (0.6%) had tested their EHRs for ICD-10 compliance and 42% responded they didn't know when they might test their systems.

More than 83% indicated that, to get ready for ICD-10, their practice-management systems either were upgraded or still need to be upgraded, will need to be replaced, or they are unsure which. The average cost per physician to get their practice management systems ready was also about $10,000, with 37% indicating the cost will be picked up by the vendor, while another 37% thought they'd have to pay and 24% was unsure just yet who would pick up the tab.

“We asked them what is their confidence that they and their trading partners would be ready, the confidence level is lowest with their health plans and highest with their practice-management systems vendors, so I'd say they're cautiously optimistic their software will be upgraded and less confident of their payers being upgraded,” said Robert Tennant, the MGMA's senior policy adviser.

“That's one of our main concerns,” Tennant said. “You can't start the testing with your external partners until you have your internal systems in place. What's disconcerting is a pretty significant number haven't heard anything from their vendors. No date. No nothing.”

For now, the compliance deadline is still 16 months away, an uneasy calm reigns. “If there is one year to go and they've still not heard from their vendor, I think the anxiety level is going to increase,” Tennant said.

Follow Joseph Conn on Twitter: @MHJConn