Having spent time in many healthcare demand markets, primarily on the clinical side … it is exciting to be involved in the HIM and Revenue Cycle Management side of the Healthcare profession. It is also unique to see how C-Level leaders and Revenue Cycle professionals are attacking the pending coder shortage and technology changes ahead. I often discuss the pros and cons of different strategies that face Healthcare executives in managing the impending coder shortage. Since reimbursements risks affect all parties in the healthcare service supply chain, Executives are faced with two choices on how to proceed with their human capital plan to support implementation and execution:
1. Choose to focus on developing in-house capabilities
2. Outsource coding to a trusted partner
As successful risk managers, many executives do not realize the risk or cost of trying to develop in-house capabilities. Not until there are issues and lost revenues with poor coding, backlog of DNFB, or other concerns do executives begin to see the significant investment of time and resources with no guarantee of on-time delivery or success. Recruiting, hiring, managing, training and retaining coders in this time of rapid change has never been so difficult or COSTLY. Healthcare organizations are not structured to support rising salaries or market demands that are occurring in the HIM space. This is especially true with productivity Declarations that will put added burden on healthcare executives responsible for reimbursements and revenue cycle. Productivity will be stalled or decline every time there is staff attrition or while employees are learning proper coding in ICD-10. The learning curve will be quite a journey – almost a “learn as you go” scenario. With ICD-10's expanded code set there is more to know and consider creating significant billing and patient issues. Michael Arrigo, Managing Partner of No World Borders states that “One of the most important risk mitigation strategies for ICD-10 will be choosing and empowering leaders. quality improvement program as well as a regulatory compliance effort. ”
In my work with leading healthcare executors who are facing the coder shortage, they value a specialist who can provide a solution to managing the impending coder shortage. It is ironic that in an industry like healthcare – that is so specialized, that often outsourcing or specialization is looked down upon as a necessary evil. According to Veronica Hoy, “Outsourcing may seem like a more expensive alternative, but it's important to consider the value of this type of expertise. and the opportunity costs of lost time, outsourcing emerges as a potential more economic and value-added alternative. ”
Leaders need to have a forward thinking approach to ICD-10 implementation and the reality of the coder shortage and productivity drains that will arise. Many successful leaders are already utilizing the expertise and specialization available to them in the market and investing accordingly. These leaders have adopted a strategy of success for the whole organization – not just a plan to get it done. In the white paper produced by the ACHE – Cost Cutting in Health Systems Without Compromising Quality – it is pointed out that “challenging times require leadership to both create the changes needed in the new environment and to keep the organization steady in its pursuit of its noble mission “. Having a true specialist and partner can ensure a successful mission.