As much as a decade ago, healthcare staffing experts were warning of impending issues in healthcare revenue cycle departments. We now have an ongoing shortage of qualified coders, simultaneous with major emerging trends that complicate this area of healthcare.
Like the nursing shortage that we have heard so much about, healthcare’s similar issue with the coding workforce looks different, depending on the region or state in question, and even down to communities. What is similar is that the availability of talent is a concern, as are possible training programs, salary differentials, and other elements that HR departments face all the time for attracting and retaining a qualified coding workforce. Many of the solutions to help solve this problem are unique to the situation.
A Growing Senior Population That Generates Care with More Complex Coding
A rising senior population is requiring more inpatient and outpatient care. Changes wrought by the Affordable Care Act and ongoing tinkering there by Congress should necessitate more coders in general—as well as more highly trained, specialized personnel within their ranks.
Coding Professional Retirements
At the same time, in 2013 the average age of coder was estimated to be 54, which meant a looming retirement wave was coming when it could be least afforded (Wirth, 2013).
A Strong Demand for Hiring Coding Professionals
There are many localities where conditions have created a shopper’s market for coders, especially those with plenty of experience and a varied skill set. These high-value hires have specific salary demands, which can run afoul of organizational leadership’s desire to control labor costs in specific lanes in the face of reimbursement challenges and competition from other providers.
Pressure from Reduced Reimbursement
Financial numbers often are bleak in the current care environment—according to some forecasts, by 2024 commercial payments to hospitals and health systems will drop from 37 to 33 percent, while Medicare payments will rise from 30 to 40 percent. Reduced reimbursements and fiscal decline will come at a time when labor, already an estimated 60 percent of noncapital costs for hospitals, will likely continue to be the largest driver of operating expenses (Korenda, 2018).
The Growing Coding Profession
At the same time, medical coding has become one of the 20 fastest growing occupations in the United States, expected to rise by 15 percent from 2014 to 2024, or 29,000 new jobs, according to the U.S. Bureau of Labor Statistics (3M, 2017).
The Demand for ICD-10 Expertise
Further complicating the picture is the recent adaptation of ICD-10, an updated set of codes to report diagnoses and patient procedures. ICD, or the International Classification of Diseases, coding was introduced in the late 1970s, and the more detailed ICD-10 replaced ICD-9 on Oct. 1, 2015. The codes form the foundation, not just of recording and identifying health conditions for study and predictive analysis, but also for insurance and government payment and reimbursement. And while the update was overdue and necessary, it made the coder’s job significantly more complicated by more than quadrupling the number of new codes from 14,000 to 70,000, which meant an immediate hit to speed, efficiency, and accuracy (Weldon, 2015).
3M. (2017). “Navigating the coder shortage: The current state of medical coding,” Retrieved from http://images.ubmmedica.com/diagnosticimaging/pdfs/navigating-the-coder-shortage-infographic.pdf
Korenda, L. (2018). No sick days, no collars: How tech might help hospitals shrink labor costs. Retrieved April 27, 2018, from http://blogs.deloitte.com/centerforhealthsolutions/no-sick-days-no-collars-how-tech-might-help-hospitals-shrink-labor-costs/
Weldon, D. (2015). Hiring woes persist as ICD-10 coders tough to find. Healthcare IT News. Retrieved April 28, 2018, from http://www.healthcareitnews.com/news/hiring-crunch-coders-leaves-many-providers-unprepared-icd-10-takes-hold
Wirth, P. (n.d.). Addressing Coder Shortages From Within. For The Record. Retrieved April 27, 2018, from http://www.fortherecordmag.com/archives/021113p6.shtml
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