Smaller healthcare providers are struggling to catch up with their larger counterparts, but across the board more organizations are embracing the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) for medical coding compared with a year ago.

Likewise, the larger orgs have progressed further and faster along the road to conducting end-to-end testing on ICD-10 before the Oct. 1, 2015, compliance deadline.

Those are among the findings in a new eHealth Initiative/AHIMA survey, which drew responses in May and June from 454 provider representatives, most whom work in hospitals and physician practices.

A report based on the survey showed 65% of all respondents ready to start end-to-end testing prior to the fourth quarter of 2015. Of these, 63% are ready to conduct testing in 2014 as soon as this year, while 17% don’t know when their organization will be ready to dig in and 10% currently have no plans.

End-to-end testing is a key indicator of ICD-10 progress, as it puts all moving parts—and, more significantly, the people behind them—through their paces in real-world scenarios that incorporate the revision’s granular specificity.

Other interesting findings include respondents’ expressing fairly widespread faith in ICD-10 to make it easier rather than harder to manage population health and to conduct clinical, health services or translational research. Some 41% said they believe the revision will ultimately improve the accuracy of claims (41%), quality of care (29%) and patient safety (27%).

On the downside, a substantial 35% said they expected their organization’s revenue to fall during the first year of ICD-10 implementation. Only 6% expect it to increase, while 14% anticipate little if any revenue impact.

While 35 percent believed their organization’s revenue would decrease during the first year of ICD-10 use, only six percent thought their revenue would increase—and 14 percent felt ICD-10 would be revenue-neutral.

Not surprisingly, smaller organizations indicated greater concern over how they would deal with decreases in revenue—along with possible hits to staff productivity—should ICD-10 implementation bring about such situations.  

Overall, however, the report authors are upbeat about ICD-10’s prospects for long-term success.

“[T]here is widespread recognition that, although ICD-10 may burden providers and organizations now, it has tangible benefits that may be realized in the long term,” they write. “Evolving healthcare payment and delivery models, like accountable care organizations, necessitate improved capacity for measuring performance, cost and outcomes. Respondents recognize that the increased specificity of ICD-10 is likely to have a positive impact in these areas, which may ultimately help to increase revenue as organizations become better equipped to meet requirements for value-based reimbursement.”

They also briefly expound on recommendations to test “early and frequently,” collaborate with regional peers and mitigate risk prior to implementation by taking such steps as dual coding to help familiarize staff with the new code set before it is upon them.

“With these strategies,” the authors write, “organizations at all points along the readiness curve will be better equipped to handle the demands of ICD-10 implementation and ultimately leverage the code set to improve performance, efficiency, and quality of care.”

The ICD system is designed by the World Health Organization and modified in numerous countries for use in healthcare reimbursement and resource allocation.

Click here to read or download the full report from the independent, nonprofit eHealth Initiative in Washington, D.C., and the Chicago-based American Health Information Management Association.