A new survey from the Workgroup for Electronic Data Interchange on ICD-10 preparations--the seventh survey since late 2009--finds a disturbing lack of industry progress during the past year.

WEDI in February 2013 surveyed 974 industry participants, comprising 87 vendors, 109 health plans and 778 providers, and compared results with a much larger sample survey in February 2012 that posed the same questions.

Results show that nearly half of responding payers expect to begin external testing by the end of 2013, but a year earlier all surveyed plans expected to begin testing in 2013. Two-thirds of vendors plan to begin beta testing by the end of 2013, which is similar to the percentage that last year expected to start testing by the end of 2012. Half of responding providers in February 2013 did not know when they would complete an impact assessment and make business changes, or when they would start to test.

Consequently, many organizations won’t start testing until 2014, says Jim Daley, chair of WEDI. The ICD-10 compliance date is Oct. 1, 2014. The Centers for Medicare and Medicaid Services recently confirmed that the date will not change; WEDI on April 11 sent a letter with its survey results to Health and Human Services Secretary Kathleen Sebelius.

Survey results actually may reflect a higher level of readiness than the industry is really at, WEDI cautions. Survey invitations were sent out through WEDI’s newsletter, via e-mail to members on the WEDI mailing list, and through partner organizations. “Historically, WEDI membership and survey participants tend to be more aware of industry issues and correspondently more advanced in addressing these issues,” WEDI notes in the letter to Sebelius, available here. “Therefore, the survey results would tend to provide a somewhat more advanced picture of readiness progress.”

Other survey results, which indicate many organizations are spinning their ICD-10 wheels, include:

* One-sixth of responding vendors have started testing, and a fifth expect to start in 2014, which is the same number that expected to start tests in 2013. One-fifth of vendors said their ICD-10 products were ready, the same number as last year. Top vendor barriers were customer readiness, competing priorities and other regulatory mandates.

* Half of vendors indicated the delay in the compliance date until October 2014 resulted in delaying the timeline of major ICD-10 projects, but did not change resources assigned to the tasks. More than half of payers also reported delaying their timeline. One-third of providers delayed their timeline more than six months, but about 40 percent said there was no delay.

* More than 40 percent of providers do not know the expected completion date of their ICD-10 impact assessment, or when they will complete business changes, both of which are roughly the same numbers as a year ago. About half of responding providers don’t known when they will start external testing, also about the same percentage as in 2012.

* Asked how they will produce ICD-10 codes, a quarter of providers expect to choose the code directly, more than half will employ both crosswalking and direct coding, and less than one-sixth expect to just crosswalk from ICD-9 to ICD-10. The total of about two-thirds using crosswalk technology is slightly above what was expected in the 2012 survey.

* Top obstacles for providers were evenly split between staffing, budget, competing priorities, vendor readiness and the impact on information systems.

* More than one-third of responding health plans in February 2012 were either complete or nearly complete with internal business process design and development, which showed considerable progress from a year earlier when one-sixth had reached this stage and another one-sixth had not yet started.

* Three-quarters of health plans expect to start internal testing “in the year before the compliance date,” which means they expect to start during 2013. Last year, slightly over half expected to test during 2012, which at the time of the survey was the last year before the then-compliance date of October 2013.

* Health plans are spilt about 50-50 between those expecting to start external testing before 2014 and those who will start after the new year.

* Top obstacles for plans include competing internal priorities, staffing issues and other regulatory mandates.

The bottom line, WEDI says in its letter to Sebelius, is that health plans have made some progress since early 2012 but vendors and providers have not. “Provider readiness appears to be a major concern in meeting the 2014 compliance deadline. Unless more providers move quickly forward with their implementation efforts, there will be significant disruption on Oct. 1, 2014. Also, there will not be enough time to do proper end-to end-testing in the CMS suggested timeframes (starting Oct. 1, 2013), as the industry will not be ready for that step.”

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