Get Prepared Now for ICD-10 and EHR Mandates

June 16

Healthcare Reform has changed the types of professionals we recruit within healthcare, but none more than information management, including Medical Coding and Electronic Health Records (EHR). While completely separate functions and mandates, both the transition to ICD-10 standards and the conversion to EHRs will demand inventive forms of recruitment to meet the demands.

It may seem like a lot to be completely converted to ICD-10 coding by October 1, 2013, but in reality it will only mean that the United States joins almost every other industrialized country's standard for reporting. Italy will be the only country not in compliance with the International Classification of Diseases' 10th revision once the US is compliant.

And while we may be playing catch-up, it is nonetheless a big deal, since we'll be going from about 18,000 diagnostic and in-patient codes with ICD-9 to a total of 140,000 codes with ICD-10. The dramatic increase in codes reflects the need for a much more granular look at what services are being provided and how they are being paid for within healthcare reform. Consequently, current coders will need to receive significant training if they are to continue in their current roles, or healthcare providers will need to participate in particularly competitive recruitment.

Many of the healthcare providers who are ahead of the curve have already set up training programs for their current coders. The total cost, not including salary and benefits (training averages 80 hours per individual), is about $500 per individual. Testing and certification cost an additional $250, but the benefits in terms of retention are tremendous. If these individuals are hired fully trained and certified, the cost-per-hire is about $3,100. Numerous schools including for-profits – both on-line and traditional – are popping up around the country, but they will not meet the demand, making the competition for these professionals intense as we draw closer to the deadline.

The salary of a Medical Coder averages $45,404 annually, but there is a big variance depending on your location, so recruiters from California whose average salary is $55,164, might be successful seeking trained and certified coders from states paying much less. Kansas has an average annual salary of $38,845, Arkansas averages $36,856, and Kentucky at $37,567.

If providers miss the deadline, they will not be reimbursed by the government or insurance companies, so you can imagine the pressure to have these individuals on staff and functional. According to a study by the American Health Information Management Association, only about 52% of the healthcare providers in this country have begun to prepare for these changes, with hospitals slightly outpacing the independent physician practices.

This transformation in medical coding will coincide with the implementation of EHR, which will present a completely different, but much more challenging recruitment and retention situation. EHR implementation will have longer and further-reaching challenges for healthcare recruitment than the ICD-10 conversation because it is much more complex, requires more highly skilled workers, demands a greater financial commitment and touches everyone in the organization.

Many healthcare systems have no idea how they are going to actually go about converting their health records to an electronic platform, so they have yet to figure out what types of professionals they need to recruit. This means that Human Resources (HR) may have received a request for a single top professional, but they have no idea what they are going to be facing in terms of overall recruitment for the project. As is often the case, as the deadline approaches and the pressure mounts, HR may be shipped numerous new requisitions with a very short turnaround in which to find and hire these highly sought professionals.

There are several steps to fulfilling the EHR mandate, and it includes selecting the software vendor, building the team, completing the project and then training just about everyone in the system. Every organization needs to establish a plan to meet their specific needs, which should begin today to ensure a smooth transition, but securing the funding for this massive project will almost certainly mean a slow and tortured transition to EHR completion.

It is not possible to train internally for most of the needed EHR professionals, so it is paramount that HR Departments begin to develop a plan. Identify the schools offering at least a Bachelor of Science in Health Information Management (University of Cincinnati, Temple, University of Kansas, Saint Louis University, Ohio State University) and start to court not only the students but the faculty and placement teams. Push your Senior Leadership to keep HR informed on what is going down, and be ready to act on those requisitions as soon as possible and probably before they become actual open positions.

Look at those few, but mostly large healthcare systems in the U.S. that have already converted their organization's records to a digital format. Employees who have already made a conversion may be ready for a new challenge and should bring incredible insight to another system. Be ready, however, to pay well and recruit strong. Individuals with a Bachelor's degree in Health Information Management earned an average of $90,970 in 2010, and individuals with specific experience and more education earned considerably more. Whatever software vendor you select will also impact the type of professional you will seek. Every vendor is different, and you will want to hire individuals with specific vendor experience to make the transition more smooth.

The U.S. government is prepared to spend up to $27 billion in the next ten years to make EHR a reality by providing incentives to facilities that embrace EHRs, and they are prepared to enforce penalties to those who don't. There are additional incentives for those systems that are able to develop and maintain an EHR system that speaks "meaningfully" to all other healthcare providers.

You'll need to start your recruitment plan now to make sure HR is equipped to hire the professionals needed for both EHR and the ICD-10 transitions.

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