Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.)

The implementation of the HITECH Act, ICD-10, HIPAA 5010, and other mandates will be among the top investments in 2011; all part of administrative simplification and the drive for systems optimization and refinement to impact quality, cost and care improvement. New HIPAA requirements will present substantial changes in the content of the data submitted with claims as well as the information available in response to electronic inquiries. Implementation will require changes to the sodtware, systems, and perhaps procedures that are used for billing Medicare, Medicaid and other paters – components of systematic reengineering of healthcare. Directly following HIPAA 5010 will be the impact of changing to ICD-10 for medical record coding and billing, another initiative that is likely underestimated, especially with expected future, on-going revisions. When undertaken, these initiatives will push many other HIT projects to lower priority. Administrative simplification, speed to market, more automated processes and streamlined project delivery will be strategically important and necessarily balanced with maintaining and enhancing current systems and gaining consumer confidence in health plans.