10/21/2015
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Proprietary and Confidential
Tami Harlan, JD Deputy Director, Arkansas Medicaid
Cathy Munn, MPH RHIA CPHQ
October 29, 2015
ICD-10: Then & Now
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● DMS Overview
● ICD-10: Then
� Preparation Efforts
• DMS
• HP
• Business Partners
● ICD-10: Now
� The First 29 Days
� Lessons Learned
� ICD-10 Next Steps
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● Department of Human Services
a) Division of Medical Services
i. 832,500 Medicaid Recipients
ii. 38,000 Medicaid Providers
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● Business Partners
� HP
� AFMC
� Value Options
� Qsource*
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● Preparation Efforts 2011 - 2012
� Cognosante Contract Signed in 2011
a) Impact Assessment
b) Requirements Gathering
� Identification & Translation of ICD-9 Codes
a) Edits & Audits
b) Medical Policy & Reports
c) Pharmacy Edits
� Collaborative effort with all business partners
a) HP
b) AFMC
c) Value Options
d) Qsource
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● Preparation Efforts 2013
� Creation of Risk & Issues Documents
a) Identification of potential risk across the agency
b) Development of risk mitigation plans
� Early Collaborative Efforts
a) AR ICD-10 Website
b) AR ICD-10 Mailbox
c) Communications Workgroup
� Provider Outreach Efforts
a) HP Provider Education Workshops
b) Over 250 Participants
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● 2013 Outreach Efforts
Date Audience Location Number Attending
May/June, 2013 Providers Little Rock 165 Participants
July, 2013 Arkansas Waiver Association Hot Springs 31 Participants
August, 2013
Developmentally Disabled
Provider Association Little Rock 94 Participants
October, 2013 Arkansas HFMA Little Rock 20 Participants
October 2013
Value Options RSPMI
Providers Little Rock
90 Participants via
Webinar
November/December, 2013
HP Annual Provider
Educational Conference
Hope
Little Rock
Jonesboro
Pine Bluff
Total of 254 participants
December 2013
AFMC Annual Medicaid
Educational Conference Little Rock
Approximately 400
Participants
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● 2014 Efforts
● Congressional Action – March 31 2014
� President signed SGR legislation into law on April 1, 2014
a) Legislation included a 1-year delay for ICD-10
� CMS announces proposed date of October 1, 2015 in IPPS
proposed rule released on April 30, 2014
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● 2014 Efforts
● Despite the delay, all ICD-10 initiatives continued:
� Creation of Content Based Testing Tool
� Creation of Transition Plan & Dashboard
� Initiation of Risk & Issues Workgroup Meetings
� Creation of Additional Provider Messaging
a) HP Provider Wire Articles
b) RA & On-Hold Messaging
c) Twitter Messaging
� Collaboration with AMS & AHA
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● Initial Provider Readiness Findings – 2014
� AFMC randomly surveyed 571 practices across the state
a) 134 Responses (23%)
� HP Provider Educational Outreach – Fall 2014
a) 5 locations across the state – urban & rural
b) Over 450 participants
� Apparent lack of preparation & readiness based on survey
findings
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● 2014 Outreach Efforts
Date Audience Location Number Attending
April, 2014
Arkansas Therapy
Association Little Rock 32 Participants
April, 2014
Value Options RSPMI
Providers Little Rock 84 Participants via Webinar
May, 2014
Mental Health Clinical
Directors Little Rock 13 Participants
September 2014
Developmentally Disabled
Provider Association Little Rock 66 Participants
October, November &
December, 2014
HP Annual Provider
Educational Conference
Hope
Pine Bluff
Little Rock
Paragould
Springdale
Total of 463 Participants
December 2014
AFMC Annual Medicaid
Educational Conference Little Rock
Approximately 400
Participants
December 2014 Arkansas Medical Society
Practice Managers
Workshop
Little Rock 21 Participants
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● 2015 Efforts
� No Additional Delays Anticipated
� Continuation of Previous Initiatives
� Additional Provider Readiness Survey Conducted
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● Follow-up Provider Readiness Survey Findings – 2015
� 134 Practices randomly surveyed in 2015
a) 66 Responses (49%)
� Expanded questions posed in second survey
a) Dual coding
b) Back-up billing plan
c) Networking with local healthcare providers
� Continued concern regarding the lack of provider preparation
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● 2015 Provider Outreach Efforts
Date Audience Location Number Attending
March, 2015
Arkansas Therapy
Association Little Rock 10 Participants
June, 2015
Value Options RSPMI
Providers Little Rock
65 Participants via
Webinar
July, 2015
DDS Children’s Services
Early Intervention Little Rock 11 Participants
July – August, 2015* Town Hall Meetings Multiple Locations 676 Participants
August 11, 2015 DDPA Providers Little Rock 55 Participants
August 12, 2015
UAMS Satellite Hospitals
and Mental Health
Centers
Video broadcast across
the state
~18 UAMS Sites across
the state viewed the
presentation
10/21/2015
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● Targeted Provider Education & Town Hall Meetings
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● Targeted Provider Education
Date Location Participants
Week 1Camden, Hope, Jonesboro,
West Memphis, Searcy
214 Participants
Week 2Fayetteville, Ft. Smith, Little Rock 208 Participants
Week 3Warren, Pine Bluff
68 Participants
Week 4Mena, Hot Springs, Bull Shoals,
Mt. View, Russellville, Conway
186 Participants
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● Town Hall Observations
� Specialty Providers were at greatest risk
a) Behavioral Health
b) Day Treatment Centers
c) Developmentally Disabled
� Positive correlation between geographic location & readiness
� Providers just want the code translations!
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● 2015 Efforts
� 90-Day HP ICD-10 Testing Window
a) June 1, 2015 – August 31, 2015
b) Over 75 unique providers tested with HP
c) Issues identified and resolved during testing
� Initiation of Transition Work Plan & Checklist
� Monthly Risk & Issues Workgroup Meetings
a) All risks were reviewed & updated monthly
b) Meeting were held with those unable to attend
c) Remediation Plans were developed
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● 2015 Efforts…..the Last 60 Days
� Development of ICD-10 Resource Collateral
a) ICD-10 Talking Points
b) Provider Call Log
c) ICD-10 Handy Resource Guide
� Extensive Training – Internal Staff & Business Partners
� Developed Daily Dashboard of Critical Metrics
� Initiation of Internal Command Center
� Daily Stand-up Calls Initiated October 5, 2015
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● October 1, 2015….
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● Week 1
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● Additional Metrics - Week 1
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● Additional Metrics
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● Additional Metrics
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● Ongoing Efforts
� Daily Calls with CMS
� Daily Stand-up Calls Continue
� Trending of Operational Metrics Continues
� Submission of Operational Metrics to CMS
� Increased collaboration with all business partners has
contributed to a successful transition
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● Types of Calls Received Included:
� When do we start using ICD-10 codes?
� I need the ICD-10 code translations
� How do I update PES so I can submit claims?
� Where can I find the ICD-10 translations?
� Why can’t you give me the translations?
� I didn’t know anything about ICD-10
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● Command Center Calls Provided Humor….
� Caller wanted to talk to the Security Officer
� Caller wanted to sell an extended warranty for a car
� Caller wanted to report a store selling “Camel Golds”
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● Resolved Issues Include:
� Submission of vision codes
� Submission of codes containing decimal point
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● Lessons Learned
� Critical Things to Remember
a) Thorough Preparation
b) Document EVERYTHING
c) Communication Among ALL Stakeholders
� Maintain a Sense of Humor
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● Continue targeted ICD-10 initiatives through the end of 2015
● Utilize data to continue payment initiatives & other areas of
focus in 2016 and beyond…
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● Questions….
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