A survey of 100 health insurers shows many view the transition to the ICD-10 code sets as an opportunity to make strategic improvements in their use of information technologies.
Some payers will use the migration as an opportunity to replace legacy core administrative systems. Others with newer systems plan to take advantage of better data analytics afforded through the more detailed code sets to improve business processes. These processes include product development, customer service, and revenue, reimbursement, care, network and risk management functions.
Payer software vendor TriZetto Group Inc. commissioned Gantry Group LLC, a Concord, Mass.-based management consulting firm, to conduct the survey. Gantry Group invited payers to take the online survey earlier this year. Half of the respondents are clients of Newport Beach, Calif.-based TriZetto; the other half uses other payer administrative systems.
The firm compared survey results with those of an earlier survey taken last fall. The commitment to use ICD-10 migration to drive additional IT initiatives rose from 31% last fall to 48% early this year among health plans with fewer than 50,000 members. Among very large plans with more than 8 million members, that commitment rose from 36% to 75%.
The survey also showed that many payers are not postponing ICD-10 preparation despite recently extended compliance deadlines for the code sets and the HIPAA 5010 transaction sets. A summary of survey results, titled, "ICD-10: The Shifting Perceptions of Payer Readiness," is available at trizetto.com/ICD-10. The summary is free but registration is required.
This article can also be found at HealthDataManagement.com.
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