Stakeholders not sure which path to follow
WASHINGTON – It seems the U.S. Department of Health and Human Services can’t ever get on the right side of the ICD-10 issue. For years it resisted calls to delay the planned implementation date of Oct. 1, 2013, as folks in the industry grappled with overlapping health IT priorities. Now that HHS finally relented, it faces the wrath of healthcare companies who bought into the deadline and have made significant progress toward implementation.
Some groups were cheered by the mid-February announcement by HHS that it would postpone the deadline, none more, perhaps, than the American Medical Association, whose delegates voted in November “to work vigorously to stop implementation of ICD-10,” and continued its campaign to do away with it in January with some well-publicized lobbying of Speaker of the House John Boehner.
The American Health Information Management Association (AHIMA) condemned the HHS backpedaling. “AHIMA sees the delay of ICD-10 as a setback to innovation and advancement in health information capture,” the organization wrote in a letter to HHS Secretary Kathleen Sebelius.
Many larger medical groups, hospitals and insurance companies have already made sizable ICD-10 investments and are left to wonder what will become of their investments.
“I think the unknown is the hardest part for providers right now,” said Christine Armstrong, principal in the healthcare and life sciences practice with Deloitte. “Do they keep going or do they stop? They are trying to decide which of the things they should keep going and which things, such as training they may need to slow down.”
Most of Armstrong’s clients are opposed to pushing back the compliance date. That echoes the results of a survey taken by health IT company Edifecs at the company's 2012 ICD-10 Summit in Cape Coral, Florida in February, just days after the HHS announcement.
“Some of the conversations we had led us to believe that a year delay, or less could help some; anything more than a year would hinder them,” said Kristine Weinberger, senior healthcare business consultant with Edifecs. “But they didn’t believe a delay was going to improve overall readiness.”
Of the more than 50 payer and provider executives surveyed by Edifecs, 90.4 percent believed HHS should more fully explore other options for bridging ICD-10 compliance before considering a delay, and 75.9 percent said a delay would negatively impact healthcare reform efforts.
This supports with the message AHIMA is trumpeting as the group makes its case that ICD-10 is the underpinning of a broad swath of reform initiatives including meaningful use, value-based purchasing, quality reporting and payment reform. “The move to ICD-10 is a defining moment for the industry,” noted Sue Bowman, AHIMA director of coding policy and compliance during a presentation at HIMSS12 in February.
That view doesn’t wash with Rob Tennant, senior policy advisor with the Medical Group Management Association (MGMA). The provider group has long been skeptical of the benefits of ICD-10 and in early March, provided HHS with seven recommendations it said would make for a smoother transition. It included requests for a more thorough cost-benefit analysis of ICD-10 for different sectors of the industry, pilot implementations and staggered implementation dates.
“We would be categorized as saying ‘unless the government takes certain action, it should not move forward with ICD-10,’” said Tennant.
Running a pilot program is a key component of the recommendations, Tennant noted, as it would allow the industry to understand and manage and solve specific coding issues that would inevitably arise, much as they have with the recent transition to HIPAA 5010.
“No other industry would go through this type of comprehensive transition without doing a pilot program,” Tenant added. “That is just common sense.”