Policy & Regulation News

Physicians Lack ICD-10 Confidence, May Retire if Revenue Low

By Jacqueline DiChiara

- As the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) implementation deadline draws nearer, tangible confirmations about bleak preparation levels among physicians and the financially dangerous aftermath of such are coming to the forefront with the release of new data.

ICD-10 implementation physician preparation

According to a recently conducted survey from the Texas Medical Association (TMA) of 936 respondents, 97 percent of which treat patients in active medical practices, and 42 percent being solo practitioners, the overall consensus regarding physicians’ preparation levels is currently quite dismal. 

Most physicians lack ICD-10 confidence, says TMA. The physicians surveyed reported a median of 31 percent of practice revenues stemming from Medicare and 12 percent coming from Medicaid.

If ICD-10 proves to be as severely financially disastrous as has been anticipated, claims disruptions, claim denials, and the like may simply drive physicians to either retire early or perhaps terminate and renegotiate their plan contracts. Some additionally confirm they anticipate having to use personal funds to keep their current practice operations running without a glitch come October.

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  • Says Tom Garcia, MD, President of TMA, “The United States is the only country that couples the ICD coding with payment. The implications are that the doctor/patient relationship is going to be stressed." Garcia additionally refers to the overall findings as simply "horrible."

    Sixty-five percent of all physician respondents confirm they have “little to no confidence” their practice will be prepared when the ICD-10 deadline hits. Only 10 percent of physicians surveyed state they are “very confident” their practice is indeed ready for the ICD-10 switch in approximately 6 weeks time. Over half of solo practitioners state they are “not at all confident” regarding their ICD-10 preparation levels.

    Age gaps in confidence levels are noted with older physicians more likely to leave their practices behind due to financial hardship, implies TMA. “Younger physicians are less than confident than older physicians,” confirms TMA. Almost half – a noted 46 percent – of physicians aged 61 or older  are more likely to retire early in response to claims being denied or delayed because of ICD-10, confirms TMA.

    Younger physicians are not immune to snagged revenue cycle hiccups and the aftermath such brings come October. Thirty-four percent of physicians aged 40 and younger are more likely to terminate or renegotiate plan contracts following ICD-10, states TMA. “Physicians employed in hospitals are least likely to be very confident their practice is prepared to transition to ICD-10,” confirms TMA. “Even among physicians who feel very confident their practice is prepared to transition to ICD-10, only 42 percent report their practice has begun transitioning extensively,” TMA adds, additionally confirming 53 percent of physicians report the staff and 46 percent report physicians within their practice have taken ICD-10 preparation courses or have completed training initiatives.

    Nonetheless, most physicians anticipate delayed or denied claims payment due to the ICD-10 transition, says TMA, and have game plans in place to prepare for what comes next. In response to cash flow problems, 36 percent of physicians confirm they will draw personal funds to fund current practice operations. Thirty-two percent of physicians surveyed confirm they plan to reduce the number of employees or slash employee hours or benefits. Whether or not such strategies are actually beneficial to the operations of the practice are perhaps yet to be determined. Will quality of care become compromised as the struggle to stay afloat endures? 

    Regarding financial planning efforts, 48 percent of physicians have set aside funds and/or secured a line of credit. Sixty-five percent of group practice owners, co-owners, and shareholders are more likely than physicians in other practices to secure a line of credit, says TMA.

    TMA confirms that among those physicians who quit treating patients within an active medical practice, almost half of them – 48 percent – quit because of regulatory and administrative burdens with nearly a quarter – 22 percent – quitting because of ICD-10.

    Regarding the aforementioned stream of statistics, it is hopeful physicians will simply be able to manage the financial realm of their practices when the ICD-10 smoke begins to clear. Minimizing the anticipated financial blows to physicans' revenue cycle is in indeed a complicated and imperative issue that demands further exploration and examination as the ICD-10 countdown ticks onwards.