Outsourced HIM and Computer-Assisted Coding Seen as Panacea for Regaining Lost Productivities and Post ICD-10 Payments, Says Black Book Hospital Survey

Optum360 is rated #1 CAC & HIM Outsourcing Services vendor across all hospitals confronting intense pressure to optimize coding processes.

​​​​​Today, Black Book Research announced for the third consecutive year Optum360 has been named the leading vendor for Computer Assisted Coding and Health Information Management Outsourcing solutions across all Hospital Chains, Systems, Corporations and Integrated Delivery Networks, as well as stand-alone inpatient facilities according the 2016 CAC survey responses of 1,865 hospital coding, medical record and financial business office leaders.

Black Book conducts polls and surveys with healthcare executives and front line users about their current technology and services partners and awards top-performing vendors based on performance based on 21 indicators of client experience, loyalty and customer satisfaction. Other top ranking CAC & HIM outsourcing vendors in the 2016 client experience and customer loyalty survey conducted from May through September this year include: nThrive (MedAssets + Precyse), M*Modal, Navicure, Nuance, and 3M Health.

Nearly 72% of hospital respondents are outsourcing more than half of their coding needs in 2016 according to the sweeping Black Book research, up from 53% of hospitals before ICD-10 in 2015, and only 20% in 2014 and 13% in 2013.

As hospitals became more aware of the potential costs savings and revenue enhancements of partnering with outsourcing companies to implement HIM process, the shift toward increased outsourcing of HIM has gained momentum.

“Outsourced coding has emerged as a compelling solution to the immense challenges of ICD-10 “, said Scott Wilson, Partner over Black Book’s outsourcing and managed services research divisions.

Ninety-six percent of hospitals over 150 beds that have been outsourcing CAC for more than 12 months respectively testified to gains over $1M in appropriate revenue and proper reimbursements following the implementation of outsourced services since Q3 2015. Additionally 92% of CAC outsourcing clients confirm quality improvements and increases to the case mix index according to survey respondents.

Consolidation in the number of CAC outsourcing vendors relied upon has also competitively narrowed in 2016. As hospitals journey through the post ICD-10 world, four in ten hospitals now work with just one vendor, showing signs that the once badly fragmented HIM outsourcing industry is meeting the ICD-10 demands of providers,” said Wilson. In 2015, 60% of hospitals outsourcing CAC and HIM were working with at least five different, external coding firms prior to the ICD-10 inauguration.

As in 2016, the lack of in-house coding IT expertise and the increased need to integrate disparate HIM systems were prime factors growing the global IT outsourcing healthcare market to a projected by Black Book at $56B by the end of 2018, added Wilson.

Key Findings include:

Of the 702 hospitals surveyed, 26% said their facilities had already increased the percentage of their CAC and HIM outsourcing since the same time last year.

According to last year’s Black Book survey, 51% of hospital HIM executives anticipated their facilities would be ready for ICD-10 by last year’s transition deadline. However, 30% of those re-surveyed in 2016 admitting falling short of that goal. Specifically, 81% of respondents that were not as prepared as they estimated, state they were regretful they did not add incremental in-house coding resources or outsourced services to address the actual productivity impacts of ICD-10.

48% of hospitals that do not utilize CAC technology or outsource prior in Q3 2016 indicate they will outsource within the next six months.

“CAC outsourcing is being seen as the panacea for regaining lost coding productivity and improving hospital financial operations,” said Wilson.

67% of surveyed CAC outsourcing clients report attributable positive financial and efficiency effects realized within 90 days.  82% of hospitals over 200 beds that outsourced coding before the end of 2016 report an increase in forecasted revenue over 4%.

The perception that CAC & HIM outsourcing was also a stop-gap solution until in-house staff and resources could be adequately prepared for ICD-10 has also shifted. Seventy-two percent of hospitals that currently outsource coding state they now intend to extend their contracts with high performance vendors until 2019.

Also changing is the acceptance of offshore outsourcing services. With coding demands rising, resources diminishing, and competencies improving, US-based CAC and HIM outsourcing vendors have partnered with offshore staffing firms.

84% of contracted HIM executives that shunned offshore coding firms and coders as much as possible in 2014. In the current year survey 22% state they would continue shying away still from a non-US workforce. 

“Offshore business process outsourcing (BPO) companies have diligently tightened policies and operations to response to HIM concerns, including advanced cybersecurity efforts, stronger service level agreements, and multiple layers of quality checks.”, said Wilson.  “All these efforts are collectively ameliorating offshore clinical coding services and improving hospital satisfaction.”

About Black Book

Black Book™, its founders, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the surveys it conducts. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges, consultation requirements, and/or vendor collaboration as Black Book polls vendors’ clients

Since 2000, Black Book™ has polled the vendor satisfaction across over thirty industries in the software/technology and managed services sectors around the globe. In 2009, Black Book began polling the client experience of now over 540,000 healthcare software and services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowd-sourced surveying to IT and health records professionals, physician practice administrators, nurses, financial leaders, executives and hospital information technology managers.  For methodology, auditing, resources, comprehensive research and Outsourced CAC and HIM ranking data see: http://www.blackbookmarketresearch.com

Source: Black Book Research LLC