Healthcare has a coding problem, and it’s not one that’s going to be solved overnight. Still, there are solutions.
The coder issue isn’t just one of staff numbers; it also has to do with education. The triple whammy of ICD-10 adaptation, a rapidly rising patient census as Baby Boomers age, and the retirement of a generation of highly skilled coders has created a crisis for hospitals and healthcare systems. To address it properly, they’ll need to not just hire, but also work to train and retrain current staff in order to maximize the efficiency of every coder.
“They need to train and develop, and also have systems in place for ongoing training to help coders get to that next level,” says Susan Gurzynski-Wells, MS, RHIA, senior product manager, revenue cycle, for HealthStream. “Education in particular is going to be vital. That’s going to help with staff quality, but also with recruitment and retention.”
Skilled inpatient coders are rare and highly prized
A big problem is that not all coders are the same. Even those who have finished coursework and obtained certification still don’t have much experience. Most of them are more than ready to tackle outpatient coding and other areas, but there’s a persistent and growing shortage of skilled coders with the depth of training and experience to tackle inpatient coding, one of the profession’s most scrutinized areas and one that has an immediate and significant impact on the bottom line.
“If you’re looking at an inpatient stay of 60 days or more, there is a lot to assess around the initial and ongoing diagnoses and treatments in order to assign the right codes,” Gurzynski-Wells explains. “And an inpatient coder will work on dozens of these every day. Ongoing audits and other oversight create pressure to make sure everything is done just right, and that’s also increased by the knowledge that incorrect or missing coding can create slowdowns or reactions in reimbursements.”
In addition to ongoing workplace education and skills enhancement efforts, innovations such as the nThrive Education Transitions Program work to train unemployed and underemployed workers in medical coding and other in-need healthcare positions. In this way, a pipeline can be created and filled so that both current and future medical-coder shortfalls can be addressed.
The program also works with existing coding populations by providing an educational ladder to allow them to learn more advanced forms of coding, including the aforementioned inpatient needs as well as same-day surgery and emergency room coding.
“Coders who have grown up in the career are getting to retirement age,” Gurzynski-Wells says. “The average age is around 54. Healthcare facilities and systems must look at replacing them, which is going to mean not just enhancing the skills of their current coding workforce, but also working with schools and outside groups to train the future generations of coders so they have a full pipeline of qualified people ready as they replace employees and add new ones to what will be a growing department for the foreseeable future.”
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