For hospitals and physician practices, a successful ICD-10 transition in the fall will largely depend on the skills and training of the coders they employ. That’s why avoiding coder turnover will be essential for all providers in the weeks and months ahead.

Yet holding onto coders may prove difficult. The coding industry has long been understaffed, and demand will only increase as providers scramble to meet the October 1 go-live date. Competition for certified coders and resulting higher wages will likely cause many to consider moving on.

Todd Gullotti, vice president of Shared Services for McKesson Business Performance Services (McKesson), said developing strategies to retain coding staff is critical for two reasons: Staff stability will help ease the transition next October, and it will also protect the investment providers already have made in training coders for the ICD-10 code set.

Keeping salary and benefit packages competitive is arguably the most important step practices can take to reduce turnover, Gullotti said. But providers should also look beyond money to consider other techniques that can improve the odds that coders will stay put. Consider:

  • Training and Education – Gullotti said organizations should be willing to provide a wide range of training and education opportunities to coders at no cost to the individual. These can include not just ICD-10-related training but any other educational opportunity that allows coders to keep pace with the almost non-stop changes in the coding field.

    “There obviously is some risk associated with providing training opportunities, since you’re making your people more marketable and some may jump ship,” Gullotti said. “But it’s a risk worth taking. Not only are you helping them improve the quality of their work, but you’re also demonstrating a commitment to their professional development.”
  • Recognition and Accolades – Simple though it may sound, providing formal recognition for a job well done can go a long way toward cementing coder loyalty. This recognition, based on a coder’s demonstrated superior quality and/or production skills, can be conveyed via a certificate, group email, one-on-one meeting with a manager, departmental meeting or some combination thereof. The process should occur at least on a quarterly basis.
  • Workplace Flexibility –Coders also should be given a range of options regarding scheduling. McKesson, for example, which employs more than 650 certified coders to support its billing and accounts receivable management outsourcing customers, allows coders to choose from 8-to-4, 9-to-5 or 7-to-3 shifts, depending on the requirements of their personal life.
  • Reasonable Job Duties and Expectations – Burnout is a problem in coding, so it is important that employers take steps to make tasks manageable and predictable. As nearly as possible, schedules should be kept to 40 hours per week. Overtime – particularly on weekends – should be avoided.

    Employers also should guard against “scope creep,” or the tendency to load coders up with ancillary tasks that aren’t central to their jobs. These can include searching for medical elements that aren’t included in the documentation, or being asked to complete other kinds of clerical work not connected to coding. Put simply, it is the duty of the employer to make daily workflows consistent, reasonable and simple.
  • Professional Respect – It is human nature for those in positions of power to sometimes take for granted the contributions others make. Highly educated physicians consequently may need to be reminded that coders have a high level of competency and are trained in a complex and difficult discipline.

    “I’m not an accountant, so I go to one to do my taxes,” Gullotti said. “And I’m not a mechanic, so I go to one to get my oil changed. Medical coding is the same kind of thing. You rely on coders because they have the expertise to do the job correctly.”

About the author

McKesson Business Performance Services offers services and consulting to help hospitals, health systems, and physician practices improve business performance, boost margins and transition successfully to value-based care.