Posted by Mark Brousseau
The banking industry has been an integral part of the healthcare world for decades, providing back-end financial administration services to health plans, ranging from processing premium payments and the financial part of the claims payments through medical lockbox services.
For banks, growing opportunities exist in the healthcare market, and revenue potential is apparent, according to Aite Group. To this end, banks are developing new products and services by applying business rules from existing products and services to cater to the healthcare space. With increased consumerism in the healthcare space since the beginning of the consumer-directed healthcare (CDH) movement, banks have been leaning on the core strengths and capabilities they have mastered in the retail environment in order to develop new product strategies, Aite Group says.
“Banks are in the unique position to be able to leverage their existing relationships with various stakeholders, including health plans, clearinghouses, healthcare providers, and healthcare vendors,” says Kunal Pandya, senior analyst with Aite Group. “Although banks’ overall focus in targeting the healthcare market is similar across the board, their approach to targeting specific areas varies widely based on their understanding of the space, relationships in the space, and overall corporate strategy.”
What do you think?
Showing posts with label EHRs. Show all posts
Showing posts with label EHRs. Show all posts
Sunday, November 7, 2010
Friday, October 1, 2010
ICD-10, EHRs Take Center Stage at AHIMA
Posted by Mark Brousseau
AHIMA's 82nd Annual Conference and Exhibit, held this week at the Gaylord Palms Hotel and Convention Center in Orlando, Florida, may not have featured "Earth-shattering new products" or "game-changing players," but it did have something that made exhibitors smile: better booth traffic.
"I can't say that I saw any new products at AHIMA," says exhibitor Greg Lusch (glusch@ibml.com), ibml's (www.ibml.com) business development manager for healthcare. But attendance at the event -- which draws coders, transcriptionists and other medical records professionals -- was noticeably higher than in recent years, Lusch adds, resulting in a steady stream of potential buyers visiting the Birmingham, Alabama-based company's booth. He attributes the increased buying interest to the "loosening economy" and strong demand for ICD-10 and electronic health records (EHR) solutions.
"There was a sense among the exhibitors that attendees had a little more money to spend," he says.
If the AHIMA conference is any indication, healthcare providers will spend a lot of that money on ICD-10 initiatives. In 2013, the U.S. healthcare system will transition from ICD-9 to ICD-10 as the HIPAA mandated code set for medical symptoms and procedures. This code set is used for billing and health insurance reimbursement, as well as statistical analysis, clinical, epidemiological and quality reporting. As a result of this transition, Lusch notes that the number of diagnosis codes will swell from 13,000 to 68,000, while the number of procedure codes will soar from 3,000 to 87,000.
"ICD-10 was by far the hottest topic at AHIMA," Lusch says. "Many attendees were there to better understand how to deal with ICD-10; how to make the transition from ICD-9 to ICD-10, what tools and updates were available to help streamline the process, and, in many cases, to find third-party services to help them figure it all out. Clearly, this was a major area of focus for AHIMA attendees."
The other area of focus for many AHIMA attendees was the conversion to EHRs. Lusch notes that in addition to hospitals and large practices -- which have been showing increasing interest in EHR solutions at conferences throughout the year -- a number of service bureaus were at AHIMA sizing up the potential opportunity, looking for EHR solutions of their own, or offering conversion services. "There is no question that more service bureaus are jumping on the EHR bandwagon, offering to scan medical records on behalf of healthcare providers. They clearly believe there is a lot of scanning business out there."
Interestingly, Lusch noted that many of the large EHR solutions vendors did not exhibit at AHIMA.
Noticeably absent from most of the exhibit hall banter was any talk of health reform. That's not to say that it didn't come up during some sessions. But Lusch thinks AHIMA attendees were "too consumed" with the major tasks of ICD-10 and EHRs to focus on the uncertainties of reform.
AHIMA's 82nd Annual Conference and Exhibit, held this week at the Gaylord Palms Hotel and Convention Center in Orlando, Florida, may not have featured "Earth-shattering new products" or "game-changing players," but it did have something that made exhibitors smile: better booth traffic.
"I can't say that I saw any new products at AHIMA," says exhibitor Greg Lusch (glusch@ibml.com), ibml's (www.ibml.com) business development manager for healthcare. But attendance at the event -- which draws coders, transcriptionists and other medical records professionals -- was noticeably higher than in recent years, Lusch adds, resulting in a steady stream of potential buyers visiting the Birmingham, Alabama-based company's booth. He attributes the increased buying interest to the "loosening economy" and strong demand for ICD-10 and electronic health records (EHR) solutions.
"There was a sense among the exhibitors that attendees had a little more money to spend," he says.
If the AHIMA conference is any indication, healthcare providers will spend a lot of that money on ICD-10 initiatives. In 2013, the U.S. healthcare system will transition from ICD-9 to ICD-10 as the HIPAA mandated code set for medical symptoms and procedures. This code set is used for billing and health insurance reimbursement, as well as statistical analysis, clinical, epidemiological and quality reporting. As a result of this transition, Lusch notes that the number of diagnosis codes will swell from 13,000 to 68,000, while the number of procedure codes will soar from 3,000 to 87,000.
"ICD-10 was by far the hottest topic at AHIMA," Lusch says. "Many attendees were there to better understand how to deal with ICD-10; how to make the transition from ICD-9 to ICD-10, what tools and updates were available to help streamline the process, and, in many cases, to find third-party services to help them figure it all out. Clearly, this was a major area of focus for AHIMA attendees."
The other area of focus for many AHIMA attendees was the conversion to EHRs. Lusch notes that in addition to hospitals and large practices -- which have been showing increasing interest in EHR solutions at conferences throughout the year -- a number of service bureaus were at AHIMA sizing up the potential opportunity, looking for EHR solutions of their own, or offering conversion services. "There is no question that more service bureaus are jumping on the EHR bandwagon, offering to scan medical records on behalf of healthcare providers. They clearly believe there is a lot of scanning business out there."
Interestingly, Lusch noted that many of the large EHR solutions vendors did not exhibit at AHIMA.
Noticeably absent from most of the exhibit hall banter was any talk of health reform. That's not to say that it didn't come up during some sessions. But Lusch thinks AHIMA attendees were "too consumed" with the major tasks of ICD-10 and EHRs to focus on the uncertainties of reform.
Sunday, February 28, 2010
The ICD-10 Challenge
By Mark Brousseau
“ICD-10 is probably one of the biggest changes to occur in health IT in 30 years,” Dr. Joe Nichols, Edifecs medical director, told attendees at the Medical Banking Project Boot Camp this afternoon at HIMSS10 in Atlanta. “It is massive.”
ICD codes, which were developed for coding institutionally related procedures, are maintained by the World Health Organization (WHO). Most developed countries other than the United States use ICD-10, Nichols noted. The United States still uses ICD-9 codes. The international version of ICD-10 contains approximately 12,400 diagnostic codes. WHO approved the U.S. version of ICD-10, which contains approximately 69,000 codes.
As of October 1, 2013, all claims in the United States must use ICD-10.
Why is this so important? Because ICD-10 is a cornerstone of healthcare information, Nichols said. “It is the standard for defining the health state of the patient, and the institutional procedures that patients may receive to maintain or improve their health state,” he explained. “This is a big change in the coding system.” What was 14,300 codes under ICD-9 will rise to 69,000 codes under ICD-10, Nichols noted, with the number of procedure codes increasing from 3,800 to 72,000 under ICD-10.
With ICD codes pervasive throughout most health systems, and many business functions impacted by the codes, it is important that healthcare organizations have plan for supporting ICD-10 codes.
“ICD-10 codes are used for a lot of things,” Nichols said. As examples, he mentioned: actuarial and financial risk; adjudication; outcomes; population health analysis; benefits design; fraud, waste and abuse analysis; quality and efficiency assessment; medical policies and clinical guidelines; payment rules; clinical history; utilization; and regulatory reporting. “We based a lot of our national policies on this,” Nichols said. “The implications are far-reaching. Imperfect mapping from ICD-9 to ICD-10 will affect processing and analytics in a way that impacts revenue, costs, risk and relationships.”
So how do you deal with this?
“If you haven’t started now, you’re going to be behind the gun,” Nichols said. But organizations need to look at their short-term goals with a long-term vision, to determine what solutions they need today, and whether those solutions will meet future needs. Organizations also need to be aware of ICD-10’s touch points with other initiatives, and the potential downstream impacts of the change. And they should collaborate with business and trading partners as they develop their ICD-10 plans. Finally, organizations should use ICD-10 to try to position themselves for competitive advantage. “There are huge competitive advantages to using ICD-10 better than your competitors,” Nichols explained.
“ICD-10 is probably one of the biggest changes to occur in health IT in 30 years,” Dr. Joe Nichols, Edifecs medical director, told attendees at the Medical Banking Project Boot Camp this afternoon at HIMSS10 in Atlanta. “It is massive.”
ICD codes, which were developed for coding institutionally related procedures, are maintained by the World Health Organization (WHO). Most developed countries other than the United States use ICD-10, Nichols noted. The United States still uses ICD-9 codes. The international version of ICD-10 contains approximately 12,400 diagnostic codes. WHO approved the U.S. version of ICD-10, which contains approximately 69,000 codes.
As of October 1, 2013, all claims in the United States must use ICD-10.
Why is this so important? Because ICD-10 is a cornerstone of healthcare information, Nichols said. “It is the standard for defining the health state of the patient, and the institutional procedures that patients may receive to maintain or improve their health state,” he explained. “This is a big change in the coding system.” What was 14,300 codes under ICD-9 will rise to 69,000 codes under ICD-10, Nichols noted, with the number of procedure codes increasing from 3,800 to 72,000 under ICD-10.
With ICD codes pervasive throughout most health systems, and many business functions impacted by the codes, it is important that healthcare organizations have plan for supporting ICD-10 codes.
“ICD-10 codes are used for a lot of things,” Nichols said. As examples, he mentioned: actuarial and financial risk; adjudication; outcomes; population health analysis; benefits design; fraud, waste and abuse analysis; quality and efficiency assessment; medical policies and clinical guidelines; payment rules; clinical history; utilization; and regulatory reporting. “We based a lot of our national policies on this,” Nichols said. “The implications are far-reaching. Imperfect mapping from ICD-9 to ICD-10 will affect processing and analytics in a way that impacts revenue, costs, risk and relationships.”
So how do you deal with this?
“If you haven’t started now, you’re going to be behind the gun,” Nichols said. But organizations need to look at their short-term goals with a long-term vision, to determine what solutions they need today, and whether those solutions will meet future needs. Organizations also need to be aware of ICD-10’s touch points with other initiatives, and the potential downstream impacts of the change. And they should collaborate with business and trading partners as they develop their ICD-10 plans. Finally, organizations should use ICD-10 to try to position themselves for competitive advantage. “There are huge competitive advantages to using ICD-10 better than your competitors,” Nichols explained.
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