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EDITOR’S NOTE: Cynthia Fry and Howard White, both from Catholic Health East, have been reporting from HIMSS 2013 in New Orleans this week. Here is the final installment of their perspective from the front lines. Fry wrote today’s story.

While the Exhibit Hall was closed on Thursday, there were still several of us diehards who stayed until the very end of the conference. Howard left at 4 a.m. Thursday to drive to Baton Rouge to catch his flight. I stayed around to hear the very last of the speakers… and it was worth it.

My day started with “Predicting Payment Impacts of ICD-10.” The speakers endorsed icd10monitor.com‘s “Talk Ten Tuesday.” The presenters seemed to think the impact of ICD-10 would last from one to two years (uh-oh). They mentioned that larger integrated systems are spending as much $20 million preparing for ICD-10.

We were told that there is a chasm in front of us. This sudden gap is going to occur on October 1, 2014, despite our best efforts. All our standard reporting metrics will shift (e.g., CMI). At a minimum, finance, HIM, and managed care need to come together to perform a multidisciplinary assessment to present to the C-level. Warren Brennan from New Health Analytics said that we each could perform this analysis ourselves.

Providers have a year’s worth of claim data that they have already coded in ICD-9, and using the GEMs tables, they can rerun the data and assess the impact. It was also stated that for significant unfavorable variances, product lines should take this information into consideration and reassess their pro formas and strategic initiatives (e.g., cardiology).

I think the best takeaway related to a comment/question from the audience by Stanley Nachimson. Nachimson said that while providers should perform the financial impact as suggested by the speakers, before any strategic decisions are made about service lines, they should perform native coding to validate the mapping findings. Nachimson said this was necessary to understand whether the ICD-9 codes used in the analysis were coded correctly to begin with.

The speakers agreed that providers should not rely on the simulation data to change strategy. GEMs is simply a vector, a directional tool.

Next, I attended the Office of the National Coordinator’s (ONC’s) Town Hall. The focus of the conversation was on interoperability. While the panelists had a lot of interesting information to share, the most interesting were the questions from the audience.

There was a bit of frustration expressed from individuals trying to access data or setting up health information exchanges. It was alleged from a physician in Cleveland that Ohio hospitals were reluctant to share their information. The physician requested that the ONC come out with a pronouncement that patients own the data, not hospitals. One member of the ONC panel shouted to the sky, “PATIENTS OWN THE DATA!”

I left the ONC session a little early to get a good seat for the final keynote speakers: James Carville and Karl Rove. While I didn’t have the greatest seat (the session filled up early, which means there were many more diehards than I anticipated), I enjoyed watching the slide show of pictures taken from the HIMSS event projected on giant screens. After a picture of Bill Clinton passed by, I couldn’t help but notice a picture of my colleague, Howard Walker, taken in the Exhibit Hall (front and center!)

Rove and Carville covered many political topics. What would you have done differently in the last election? What are your thoughts on the next Presidential election? What about sequestration? What about healthcare? What about immigration reform?

I would recount any of these conversations if I thought that they would be of value to this audience, but the thing that struck me yesterday (which I did not report about the Clinton speech) and today in what Carville said is that there is a lack of understanding from the Democrats about the cost shifting occurring in healthcare.

Carville described Medicare and Medicaid as the best lowest-cost programs and that they were both run by government. Both Clinton and Carville referred to the Time magazine article (“Bitter Pill, Why Medical Bills Are Killing Us,” Steven Brill, Feb. 20, 2013) as required reading and referenced hospital charge structures as being out of control and not transparent (Note: I am particularly sensitive to this, being a VP of Revenue, and I only wish I had five minutes to counter the Brill Times article). Rove explained the cost shifting to the audience, which was correct (Note: I am endorsing neither party and kept Clinton’s comments out of my commentary yesterday, but after today, feel compelled to report).

Both Carville and Rove thought immigration reform was possible in Congress despite the gridlock on other items. Both also agreed that local elections (Congress and Senate) were more important than the Presidential.

In the end, both said they were optimistic about the future. Rove said our country gives people a chance to achieve. Carville said we have better young people than we deserve and that we have provided them a tough job market. He said that our young people are remarkable and will have to “unring a lot of the bells that shouldn’t have been rung.”

I, as I am sure many other of my colleagues, leave HIMSS with a renewed sense of purpose and I am grateful to my employer for allowing me the opportunity to attend such an educational, mind-altering, and prestigious event.

While I am not happy that my plane is delayed and I will be arriving home around 1 a.m., I wouldn’t have traded the experience.

Au revoir from New Orleans (and looking forward to Orlando next year),

Cindy & Howard

About the Authors

Cynthia D. Fry is vice president of revenue for Catholic Health East, a multi-institutional, Catholic health system located in 11 eastern states from Maine to Florida. Cynthia leads the revenue management initiative, which is designed to improve operational performance through synergistic efforts across CHE’s various entities, and is also CHE’s executive sponsor for ICD-10.

Howard Walker is director of revenue cycle systems and projects and the Catholic Health East ICD-10 program manager. Prior to CHE, Howard was a manager at Accenture in the healthcare practice. Howard has his bachelors from Villanova and his M.B.A (May, 2013) from Penn State.

Contact the Authors



To comment on this article please go to editor@icd10monitor.com


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