Migration from the ICD-9 to ICD-10 code sets is one of the most extensive and risky conversion projects healthcare insurers will face. Conversion will impact organizational structure, business processes, healthcare policies and IT systems. The scope of this change presents significant risks to insurers seeking to achieve financial and benefit neutrality to avoid undermining provider relationships. Insurers will require scalable, high-performance healthcare data transformation as well as comprehensive testing and automated comparison of ICD-10 results versus expected outcomes.
Analytics that use ICD procedure and/or diagnosis codes will change dramatically under ICD-10. The challenge will be in determining how best to take advantage of the greater level of condition, diagnosis and treatment data that will be available after healthcare organizations migrate to the ICD-10 code set. Business intelligence solutions will need to support ICD-9 and ICD-10 codes simultaneously during the transition. Reporting, efficiency and population risk models or other aggregation schemes must be fully remediated to support native ICD-10 as well as native ICD-9 codes. Architectural solutions must support technical platform compatibility and ease of integration in existing models.
In this informative webinar, we explore how to leverage the increased data granularity in the ICD-10 code set. While there are risks, a properly executed ICD-10 implementation will deliver plentiful rewards.