"Outsourced coders are too expensive", "My internal coding resources are much less expensive than external coders" are statements I hear frequently from HIM leaders. Having worked on both sides of the fence as a HIM department lead on the provider side and now as Chief Operating Officer for himagine it struck me; has this cost gap between internal and external coders ever been quantified or is this more of a perception?
Working in a variety of provider settings, ranging from a large, multi-facility health system to a county-owned, short-term acute hospital, has given me a unique point of view on the engagement between HIM and the revenue cycle function. Even in cases where HIM reported directly to the vice president of revenue cycle and ultimately the chief financial officer, I typically felt that awareness of the challenges the HIM Director faced on a day-to-day basis was lacking.
HIM departments across the country are continually challenged to retain their most highly skilled professionals. Quality coders are in high demand and HIM professionals are looking more and more to enhance their career opportunities. As a long time HIM department leader I have experienced first hand the difficulty of developing career paths for employees. The good news is that the HIM segment is poised for continued growth with job opportunities expected to grow by 15% by 2024. With a little planning and a commitment to your people you can make your facility a “destination” for HIM professionals.
In 2015, himagine conducted its inaugural HIM Benchmark Survey in the midst of the preparation for ICD-10. At the time, approximately 56% of respondents reported that they planned to outsource at least a portion of their coding. In our 2016 survey, 63% of respondents indicated that they outsource, making it clear that most healthcare providers currently rely on some coding vendor resources and will likely continue to work with outsourced coders going forward.
In our soon to be released second annual HIM Benchmark Report, 70% of HIM leaders indicated they increased auditing efforts in 2016 and a whopping 96% projected to maintain or increase this level of auditing in 2017.
April 1st officially marks six months since the transition to ICD-10. While we’ve had six months to adapt to the effects of the new coding set, we only have six more before the continued expansion of the ICD code set takes effect when the partial freeze on updates implemented by CMS is lifted. This expansion will introduce another 1,900 diagnostic codes, 3,651 inpatient procedure codes, and 487 revised code titles. Come October 1st 2016, the HIM industry will again experience sweeping changes in medical coding making highly trained medical coders more desirable and the “great coder shortage” more daunting.
An experienced medical coder brings not only enhanced productivity due to application of appropriate codes, but also knowledge of the diagnosis and procedure coding proclivities used by an organization’s healthcare professionals. They are also able to identify potential red flags and other nuances that can affect reimbursement. The benefits of working with highly trained coders are obvious as are the disadvantages of losing such coders; coder turnover disrupts productivity, which can lead to coding backlogs and increased DNFB along with higher administrative costs associated with backfilling open positions.
We, at himagine solutions, have admittedly been busy over the last few weeks with ICD-10 related activities as I am sure you have as well. We did find some time however to launch our Inaugural HIM Benchmark Report with the aim of better informing the HIM community about the modern day opportunities and challenges effecting their facilities. We surveyed 140 HIM Leaders on everything from the challenges facing their HIM Department to details on how they manage outsource vendors.
We are proud to now be able to share the results of that report, along with some of our additional insights, with you.
As a medical coding professional it may seem that the greatest challenges present themselves not in the classroom or at your desk, but within the competitive job market. Making the decision to change jobs is not something that is taken lightly; one must consider stability, education, growth, benefits, management support, work/life balance, and financial impact. There are many myths and rumors about working for a coding vendor versus a hospital/healthcare provider that can be misleading.