As we kicked off 2019, I reached out to a number of people I know in the HIM industry to get their predictions on what HIM professionals should watch for in 2019. They offered up a pretty interesting mix of predictions around regulations, the shift to value based reimbursement, and the changing role of HIM.
First up, let’s hear what AHIMA has to say with Mary Butler – Associate Editor, Journal of AHIMA along with insights from Lauren Riplinger and Melanie Endicott.
1. Coding and CDI Grapple with New Payment Models: In addition to routine coding regulation updates, this year coding professionals will be focused on complying with quality metrics and getting paid for value over number of patients seen, according to Melanie Endicott, vice president of HIM practice excellence at AHIMA. In addition, a new payment model for skilled nursing facilities will be released October 1, and will formally require the use of specific ICD-10-CM codes.
2. HIPAA Modernization Will Continue: In response to the rise of opioid use in 2018 (and other information sharing barriers), The Department of Health and Human Services Office for Civil Rights (OCR) is seeking input from the public on how the HIPAA rules could be modified to promote value-based healthcare. According to Lauren Riplinger, AHIMA’s senior director for federal relations, AHIMA will continue its work to address issues like patient matching and the alignment of privacy laws at the state level.
3. More to Come on 21st Century Cures and Interoperability: The industry awaits the second draft of the Trusted Exchange Framework and Common Agreement (TEFCA) which will help create a common set of principles for trusted exchange of electronic health information. AHIMA anticipates that the final version will enhance interoperability in the industry.
Next up is Stephanie Crabb, Principal at Immersive.
The execution of AHIMA’s Vision for Transformation in 2019 will be critical to the profession. Solidifying and growing HIM’s value to the revenue cycle must remain core. But HIMers that harness their skills and talents, and lean in early to emerging disciplines like care coordination, patient experience, data management and risk management will be instrumental in HIM’s reinvention.
And it wouldn’t be an HIM roundup without insights from the incomparable Rita Bowen, MA, RHIA, CHPS, CHPC, SSGB, Vice President, Privacy, Compliance and HIM Policy at MRO.
HIM’s Role in Cybersecurity: Though cybersecurity is traditionally handled by health IT departments, I believe 2019 will be the year that HIM professionals become much more involved in cybersecurity planning and program execution. Cybersecurity is a top concern for healthcare leaders at all levels. HIM’s expertise for protecting health information will be recognized and valued as organizations strengthen their cybersecurity policies in the year ahead.
Attorney Misinterpretation of PDRs: During the AHIMA annual convention 2018, a standing-room-only session focused on attorney requests submitted under the guise of a PDR. Attorneys are attempting to receive records from HIM departments for the nominal fee designated for patients only. This issue requires further clarification and guidance in 2019—before HIM departments experience significant financial loss. Key AHIMA and AMIA members presented the issues to legislators during a Capitol Hill briefing on December 5, 2018.
Increased Data Collection and Protection: Technology will continue to advance in 2019—becoming faster and safer. More points of data collection drive greater demands for data accuracy and protection. HIM leaders must decide what data to protect, what policies and procedures to update, and how to inventory all their data. Leadership’s goal is for patients to have a connected, fluid experience throughout the healthcare journey. Achieving that goal requires accurate and relevant data. I predict HIM professionals will play an increasingly important role in data integrity and further defining the flow of health information, specifically as it relates to patient-directed application program interfaces, APIs.
And finally, an HIM prediction from Sarah Humbert, RHIA, Vice President of Coding Operations at KIWI-TEK.
I believe in 2019 we will continue to see health systems move to single platform systems. With this continued transition I believe that we will see the development of specialized teams within the revenue cycle team; these include specialized teams for edits review and resolution, further coding specialization with in the coding work queues; specialized team members to work denials; continued movement of professional fee coding to certified coders.
A big thank you to each of these people for offering their predictions into the world of HIM. What’s your prediction for 2019? What do you see happening that HIM professionals should know about? Please share them in the comments or on Twitter with @healthcarescene.