WEDI survey: ICD-10 readiness still underwhelms

'This lack of progress is cause for concern'
By Erin McCann
11:08 AM
Stressed doctor
WEDI's newest survey of ICD-10 readiness among vendors and providers is out. And the progress report is not as promising as officials had hoped. In fact, it appears as the ICD-10 delay has actually had a negative impact on progress. 
WEDI, or the Workgroup for Electronic Data Interchange, surveyed nearly 1,200 vendors, providers and health plans to gauge their readiness for the ICD-10 go-live date of Oct. 1, 2015. But, as the organization emphasized, the results were underwhelming. Vendor readiness remained relatively unchanged since August 2014, and providers? Well, they're actually falling behind. 
"Unless all industry segments make a dedicated effort to continue to move forward with their implementation efforts, there will be significant disruption on Oct. 1, 2015," wrote Jim Daley, past chair of WEDI in a March 31 letter to HHS Secretary Sylvia Burwell. Two-thirds of providers, in fact, said they had slowed their ICD-10 efforts or halted them altogether as a result of the delay. 
Other provider results:
  • About 33 percent of the 796 providers surveyed said they had already completed their ICD-10 impact assessments, a decrease from WEDI's August 2014 survey when more than 50 percent of providers said they had completed the task. Moreover, more respondents also indicated they would be completing their risk assessments in 2015 than in the prior survey.  
  • In regards to starting external testing, there was also a decrease in the percentage of providers ready. Some 25 percent of them indicated they had begun external testing, representing a decrease from August 2014 when 33 percent had started this task. More than 25 percent of providers said they expect to begin testing by the second or third quarter of 2015. 
  • For Medicare testing, a quarter said they had already tested with Medicare, and about 20 percent said they had no plans to test with Medicare. 

"This lack of progress is cause for concern as it will leave little time for remediation and testing," WEDI officials wrote in the March 31 letter discussing report findings.

With three delays to date for the ICD-10 coding implementation start time, it's no surprise that the lion's share of providers – more than 50 percent – cited "uncertainty over future delays" as a key obstacle causing stymied progress. Other challenges for providers were staffing and competing priorities; vendor readiness; budget; and IT impacts. 
"It appears the delay has had a negative impact on some readiness activities, especially external testing," WEDI officials concluded. 
Some say providers will never be ready. William Jefferson Terry Sr., MD, who spoke on behalf of the American Urological Association in a February Capitol Hill hearing, told policymakers that small physician practices would never be ready to adopt the new code set, as many of them could go out of business for coding incorrectly. 
The "potential benefits (of ICD10) are not documented,"Terry told lawmakers, and it's proven to be a costly mandate that "will certainly put some physicians out of business."
John Hughes, MD, a general internist and professor of medicine at Yale School of Medicine, disagreed, saying that ICD-10 proved crucial for improved specificity and accuracy of medical complications. "The ICD‐9 coding system fails to provide the level of detail needed to expand these efforts" of addressing medical complications, he said before the panel.

Vendor results: 

  • About 60 percent of the 173 vendors surveyed said their ICD-10 services and software were either available or they had kicked off customer testing, down from about 67 percent back in August 2014. Another 25 percent said their products would not be ready until the second or third quarter of this year. 
  • Some of the challenges vendors cited with ICD-10 readiness was similar to that of providers: uncertainty over additional delays, at 50 percent. Customer readiness and other competing priorities were also significant obstacles. 
In the February ICD-10 hearing on Capitol Hill, Kristi Matus, chief financial and administrative officer of cloud EHR vendor athenahealth, urged lawmakers to keep the coding start date of Oct. 1, 2015, or ditch it altogether. "Repeated delays in deadlines" further "undermine the government's credibility and impede progress on crucial initiatives," said Matus. "Do not again kick this can down the road," she said. "Pull the trigger, or pull the plug."

Health plans results:

  • The 205 health plans that participated in the WEDI survey fared slightly better than their provider-vendor counterparts when it came to ICD-10 readiness. 
  • The lion's share of them, 80 percent in fact, said they had begun internal testing, with 40 percent of them that have already have completed the task. "This represents good progress," WEDI officials wrote, as it represents about a 5 percent increase from last year. 
  • Regarding external testing, nearly 25 percent of health plans said they were planning to test with most providers, and 60 percent would test only with a select group of providers. Another 10 percent indicated they would only test with clearinghouses. Just more than 50 percent of them have already started external testing. 
  • For 60 percent of health plans, the No. 1 biggest challenge that has impacted ICD-10 readiness is competing internal priorities. Uncertainty over delays also topped the list.