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Opposing Viewpoints: Provider Organizations Give Differing Perspectives on What the ICD-10 Delay Really Means

April 11, 2014
by Rajiv Leventhal
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Is the delay as harmful as many say? Execs from two patient care organizations react

With the news now confirmed that the transition to ICD-10 will be delayed another year, various industry groups have made their disappointment clear, expressing a strong desire that another delay will negatively impact the healthcare industry.

Certainly, provider organizations are worried about how the delay will affect their financials—after all, the Washington, D.C.-based American Health Information Management Association (AHIMA) expressed deep disappointment in the results of President Obama signing the “doc fix” bill into law, estimating that another one-year delay of ICD-10 would likely cost the industry an additional $1 billion to $6.6 billion on top of the already incurred costs from the previous one-year delay. 

That being said, not everyone sees the delay exclusively as a negative. A recent report from Fitch Ratings, a New York City-based global rating agency, concluded that a one-year extension of the deadline for hospitals and payers to transition to ICD-10 is viewed as a positive credit development for not-for-profit hospitals. Further, there have been conflicting reports on how ready payers were for the transition; some say the large payers were ready, others say that a significant amount of all payers were not.

To get a better idea of the differing perspectives on what the ICD-10 delay means for the industry, Healthcare Informatics spoke separately with executives from two provider organizations to gauge their opinions. Below are excerpts of interviews done with Stacey McIntosh, solution partner and project manager for the Houston-based 12-hospital Memorial Hermann Health System; and Glenn Harnett, M.D., medical director of American Family Care, an urgent care center with more than 100 facilities spanning 26 states. Joining McIntosh and Harnett for the article is Eric McDonald, CEO and founder of DocuTAP, a Sioux Falls, S.D.-based provider of integrated electronic medical records (EMRs) and practice management technology for urgent care practices. DocuTAP is the vendor used by American Family Care in preparation for its ICD-10 transition.

HCI: What was your in-the-moment reaction to the news that ICD-10 will be delayed again?

McIntosh: We are a big organization, so there were mixed reactions across the board. But our general consensus was, “Are they crazy?” If not now, then when? And realistically, we could be in the same boat next year. So we would have preferred to move forward as opposed to having another delay. There was definitely a scramble, and we were being told to call our congressmen and our senators; everyone seemed to be caught off guard and was asking why the ICD-10 element got included in this bill. That being said, we will take an optimistic approach to this and revamp, revise, and optimize some of the more troubling areas. Going forward, the delay will allow us to optimize time and make problems work. For one, technology readiness has been a challenge for us. It also will give us a better stance in working with vendors and the timelines that they may have been struggling with.

Harnett: Truly, I couldn’t have been more pleased. I felt like our company and our vendor had the ability to be ready for this fall, but we had the feeling that the majority of our insurers weren’t going to be. Giving the insurers more time to get on board and be prepared is a good thing.

Glenn Harnett, M.D.

Also, we have meaningful use Stage 2 starting this year as well, so that is a big focus for us clinically, being able to meet those new measures and moving forward with our vendors. The two of them [ICD-10 and MU] combined were creating new hoops to jump through. But there was more concern with our cash flow—if the payers weren’t ready, we would have a significant delay in getting paid for the services we provide. So, whoever decided to put this in the Medicare “doc fix” bill was brilliant.

HCI: How ready for ICD-10 was your organization prior to the delay and how will the delay affect you going forward?

McIntosh: We did feel confident moving forward, since we did Centers for Medicare & Medicaid Services (CMS) testing with the big payers. And we will do more testing, but will delay that until the fall now. This does affect us [negatively] from a financial standpoint, especially with contracts from our vendors. It also affects the education extensions, since we had to cancel all 48 physician training sessions with specialties across the system. We will still pursue that, but will delay that towards the fall as well. So when it comes to the education of the coders and physicians, while we will still pursue those avenues and keep them going, we will have to extend them and pay for those extensions. You have to keep things fresh, because if you don’t use it, you lose it—and that keeps the costs adding up.