ICD-10 Compliance: IBM Strategies to Create New Value


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IBM can help your business to realize optimal business value from ICD-10 adoption with the right investment at the right time. The ICD-10 compliance solution from IBM helps to reduce risk, accelerate implementation and minimize the costs of transformation with a proven SOA framework.

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ICD-10 Compliance: IBM Strategies to Create New Value

  1. 1. IBM Sales and Distribution Solution Brief ICD-10 compliance The Department of Health and Human Services (HHS) has Highlights mandated that all healthcare providers and health plans implement the International Statistical Classification of Diseases and Related ● Develop a plan to support your ICD-10 Health Problems, 10th Revision (ICD-10) by October 1, 2013. adoption business strategy The Centers for Medicare and Medicaid Services estimate that the ● Create a scorecard for each department industry will spend US$7 billion to comply with ICD-10 requirements. with specific, actionable business and The choice of implementation approach has potential to differentiate technical recommendations your organization. ● Prepare project plans, timelines, staffing profiles, implementation timelines and cost estimates Establish an optimal ICD-10 transformation strategy ● Build an oversight plan with strategies for future updates Organizations that react to ICD-10 legislation as simply a compliance mandate risk the possibility of unpredictably large costs and small value realization. Alternately, they can choose an innovative strategy and take full advantage of the greater business value offered by ICD-10 codes to offset anticipated costs. The ICD-10 compliance solution from IBM includes separate but integrated engagements, from strategic planning to final execution of the more tactical initia- tives, to deliver the optimal value for ICD-10 adoption to your business. Enabling your transformation The ICD-10 compliance solution is composed of four integrated engagements: ● The ICD-10 strategic assessment which is designed to help plan an ICD-10 adoption strategy by evaluating the current state of the business. ● The ICD-10 implementation roadmap begins with plans developed in the strategic assessment to help prepare project plans, timelines, staffing profiles, implementation timelines and cost estimates.
  2. 2. ● ICD-10 business and technical project implementation offerings use IBM’s experience, technical and business process assets and proven service oriented architecture (SOA) framework to reduce risk, accel- erate delivery and minimize the costs of ICD-10 transformation. ● Our ICD-10 shared oversight and roadmap refresh team engages IBM senior consultants to jointly share responsibility with you for © Copyright IBM Corporation 2009 building a roadmap for future updates, from assessment through IBM Corporation ICD-10 business value delivery. Route 100 Somers, NY 10589 Engagements can be purchased separately or packaged for joint sharing Produced in the United States of America December 2009 of responsibility with IBM. Organizations that adopt ICD-10 earlier All Rights Reserved will be able to better prepare and optimize plans that outline short- and long-term budget requests and the supporting business cases. IBM, the IBM logo and ibm.com are trademarks or registered trademarks of International Business Machines Corporation in the United States, other countries, or both. If Align healthcare initiatives with these and other IBM trademarked terms are marked on their first occurrence in this information with a trademark symbol ICD-10 adoption (® or ™), these symbols indicate U.S. registered or common The ICD-10 compliance solution can deliver business, process, people law trademarks owned by IBM at the time this information was published. Such trademarks may also be registered or and technology improvements. Compliance with ICD-10 offers the common law trademarks in other countries. A current list of opportunity to: IBM trademarks is available on the Web at “Copyright and trademark information” at ibm.com/legal/copytrade.shtml ● Establish more accurate underwriting and product offerings. Other product, company or service names may be ● Base coverage on condition, not only treatment approach, for cover- trademarks or service marks of others. age precision. ● Spot high dollar conditions sooner. Please Recycle ● Gain better understanding of medical conditions by member, group and population. ● Recognize providers that are treating patients with more acute conditions. ● Enhance pay-for-performance initiatives with significantly more pre- cision in payment by procedure. ● Reject fewer claims and establish more precise services approval. ● Process fewer fraudulent claims and identifying misdiagnosis up-coding. The ICD-10 mandate can be a catalyst to an organization’s transforma- tion plans. IBM’s fundamental concept is to consider the ICD-10 man- date as a potential business opportunity, rather than just another compliance project. Our experience tells us that with an incremental investment, sufficient business value can be generated to cover compli- ance cost, as well as deliver a potential return on investment. For more information To learn more about the ICD-10 compliance solution, please contact your IBM representative or IBM Business Partner, or visit: ibm.com/healthcare. HLS03021-USEN-00