Ready for another bureaucratic
headache? On October 1 of this year, under federal government
rules, most medical providers and insurers will have to switch over
to
ICD-10, a new coding system for patient diagnoses and inpatient
procedures. The new standard has almost ten times as many codes as
ICD-9, which it supersedes. That’s supposed to allow for greater
precision. It also increases complexity, however,
as I’ve reported, and has the health industry concerned over
confusion and costs in the course of the massive transition.
The ICD-10 changeover would be daunting no matter what, but the
hard deadline plays a big role in fears. Last week, Marilyn
Tavenner, administrator of the Centers for Medicare and Medicaid
Services,
insisted that the deadline is firm and fast (it was already
delayed once), though CMS may allow for some hardship exceptions.
That’s not really calming anybody, as Grace-Marie Turner and Tyler
Hartsfield of the free-market Galen Institute note in an
op-ed for Investors Business Daily which refers to
ICD-10 as an “avalanche of time-wasting paperwork for doctors.”
Dr. Susan Turner, president and CEO of Medical Group Management
Association (MGMA), says the transition will be “one of the most
complex and expensive changes our health care system has faced in
decades.”The ICD-9 has about 17,000 codes, while the new ICD-10 will have
more than 140,000. These cumbersome new administrative
responsibilities will take away from the time doctors can spend
with their patients. …In a recent letter to HHS Secretary Kathleen Sebelius, Dr. James
Madara, CEO of the American Medical Association, said it will cost
a small practice up to $226,000 to comply. And there is no
opportunity to phase in the new system and iron out glitches. (We
saw how this worked out with the ObamaCare website … )Because this coding system directly facilitates payments,
physicians who do not transition on time will experience a delay or
cessation of payments. To weather this transition, CMS suggests
that small and medium-size practices should have access to “reserve
funds or lines of credit to offset cash flow challenges.”
Turner and Hartsfield refer to Canada’s somewhat speed-bumpy
transition to ICD-10 a decade ago. That changeover,
according to Carl Natale of HealthCareITNews, was
staggered over the period from 2001 to 2005. Natale cites Gillian
Price, who was a consultant for Canadian healthcare organizations
during the transition.
Speaking of productivity, it tanked. The reduction ranged from
23 percent to 50 percent. And Price said productivity never fully
recovered. There was no way it could given the complexity of the
new codes and the changes needed in the healthcare
organizations.
Natale’s 2011 article doesn’t bash the new coding system, but it
does provide some hard lessons acquired over a phased-in adoption
of the system. It’s hard to see how the American experience,
planned for one day while the system is already reeling from
Obamacare, will be easier.
As it turns out, my wife and her fellow pediatric providers are
spending their lunch today going over ICD-10 changes at the local
hospital. They’re not even affiliated with the hospital—my wife’s
practice is independent—but they round on newborns whose parents
pick them as their pediatricians. In the course of rounding, they
need to know a couple of codes that will update with the new
system. That apparently requires an hour-long meeting.
The rest of ICD-10 my wife is handling in-house, including
training, updating her electronic health records system, and
socking away cash reserves. So far, she’s pretty confident in her
preparations. She’s leaning on payers on whom she relies
(**cough** Medicaid **cough**) to test their
systems.
October 1 is also supposed to be the next deadline after which
health plans must be Obamacare compliant to be renewed,
if that isn’t delayed.
For people who like watching bureaucratic trainwrecks, this
promises to be an interesting year.
from Hit & Run http://ift.tt/1f8aktU
via IFTTT