Over the last few months, there seems to have been an endless string of stories focused on the how ICD-10 will change the entire industry – specifically how clinicians will be impacted. While the clinical side will need to ensure more detailed documentation occurs, the business side of healthcare will also have to adjust their workflow and habits for the new code set.

To have a successful ICD-10 implementation, practices are going to have to understand key operational revenue cycle metrics and what they mean to the practice’s bottom line. Here are some suggestions to help manage the business side of ICD-10:

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An article in CNN Money not too long ago entitled “Doctors Going Broke” really made me stop and think about how difficult it is to operate a medical practice.

There is no doubt that owning a medical practice may be one of the most challenging businesses out there, especially since physicians historically have little business training and virtually no control over costs or pricing. With sobering statistics like one from the Small Business Administration that says more than 50% of small businesses fail within the first five years, it’s a wonder doctors have survived as well as they have.

If a physician were to write a completely honest advertisement for a franchise opportunity, in fact, you could expect to read something like this:

Exciting opportunity in the ambulatory office space! Invest $300,000 and 6 years of your youth in grueling academic setting to obtain medical degree. Serve an ever increasing supply of unfunded clients who believe it is your obligation to provide service with no understanding of their financial obligation. Partner with insurance companies, who are well funded and outman you 10 to 1, to define your compensation plan. Bask in the glow of federal and state regulations that continuously increase government oversight and restrictions on the way you run your business. No business experience required.

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The Medical Practice Management Association® (MGMA®) just wrapped up its annual conference with record attendance last week. As I participated in the meeting, I was struck by the diversity of the audience. While the more traditional attendees from large practices were present, the meeting also appeared to draw quite a few smaller practices this year, such as those in the one-to-three provider range.

That probably shouldn’t be surprising. Many vendors are seeing an uptick in the number of small practices now embracing and adopting electronic health records (EHRs), and MGMA presents a logical place to gain information, network with other providers, and learn how to address common implementation stumbling blocks. Basically, MGMA has the playbook on how to implement this type of technology, and smaller practices as well as newer ones can benefit from this knowledge.

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Last week I had the pleasure of attending an industry event in Atlanta, where practice administrators and physicians gathered to discuss best practices and success stories for using clearinghouse services as well as other practice management technology. On Thursday afternoon I was able to sit in on a panel discussion where four speakers from four different practices talked specifically about their experiences with clearinghouses. During the session, each panelist focused on how their clearinghouse helped their practice enhance workflow and increase profitability.

During the hour long event, I noticed that all four of the panelists mentioned that they had leveraged elements of their clearinghouse to support growth without the need to hire additional staff. One person even mentioned that her practice now includes 28 physicians after merging with another group—but she works with the same six billers she worked with prior to the merger.

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We are happy to announce the launch of a new website – ICD-10 Hub – which is part of a new partnership between Navicure and AAPC. The purpose of the site is to provide all medical practices with helpful information and in-depth resources to assist with the 5010 and ICD-10 transitions. ICD-10 Hub will compliment and bolster the practice management information you already receive on this blog.

Devoted to helping every practice successfully move to 5010 and ICD-10, ICD-10 Hub allows you to download webinars, read blogs and catch up on the latest news the industry has to offer. Some of the content currently available includes:

• 5010 Timeline – This one-page overview details what steps you and your technology vendors should be taking, plus when to successfully transition to 5010.
• ICD-9 to ICD-10 Mapping – This reference sheet lays out how ICD-9 codes translate to ICD-10 codes.
• 5010 Payer Announcement Updates – This “living” document relays the steps each individual payer has taken and is planning to take in the near future to ensure their preparedness for 5010. This information will be updated frequently with the latest information you need to know.
• Recorded Webinars – Multiple webinars, which each focus on a different aspect of the transitions, are available for free download from the site.

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The prospect of obtaining stimulus funding has, not surprisingly, created an environment of intense focus on Electronic Health Records (EHRs). While that’s OK, I see a distinct limitation in looking at EHRs, practice management systems (PMS) and other applications as isolated pieces of hardware/software. Instead, I think the current atmosphere provides many practices the opportunity to step into completely new systems, with a completely new way of viewing the components.

Rather than contemplating an EHR purchase or PMS evaluation in the context of “what’s available,” consider how well these technologies will serve as your platform from which to custom-build, taking into account future needs as well as current ones. Read More ›

You’ve probably heard it before, but it is worth reiterating: Start preparing to transition to ICD-10 now. Most experts believe, with good reason, that the 2013 deadline will not be delayed. Those who are not prepared to correctly submit ICD-10 codes on the implementation date simply will not get paid.

The magnitude of the change is no small matter, either. The roughly 14,000 now-familiar ICD-9-CM codes will be replaced by about 69,000 ICD-10-CM codes; the current 4,000 or so ICD-9-PCS codes will swell to about 72,000 ICD-10-PCS codes. In all settings, physicians will need to provide much more explicit documentation. Read More ›