Continuing silence from CMS on ICD-10 delay launches more industry analysis

After ICD-10 was officially delayed due to the particular language of a fast-approved bill earlier this month, many industry professionals expected a quick reaction from the Centers for Medicare and Medicaid Services. The CMS and Department of Health and Human Services Secretary Kathleen Sebelius both had trumpeted the importance of a transition to updated services such as orthopedic billing codes. After such a protracted fight against the tacit resistance from some health care provider groups, the sudden and enduring silence of the CMS following the passage of the delay has caused many physicians and administrators to wonder.

The recent resignation of Sebelius has prompted those same health care professionals who expected to receive detailed guidance on what to do with their suspended preparations processes to turn their inquiries back to themselves. Speaking to EHRIntelligence, Erik Newlin, co-chair of the ICD-10 Assessment Workgroup at WEDI and director of national standards consulting at Xerox, emphasized that some health care professionals may want to see the ICD-10 delay as an opportunity.

Rethinking the delay
Knee-jerk reactions from health care professionals to the ICD-10 delay included frustrations over the suspension of their costly preparations and a lack of information on how to proceed with their activities. However, the CMS' silence about a future ICD-10 transition date has led Newlin to approach the vacuum as a positive rather than a negative. 

Newlin told EHRIntelligence a successful reenvisioning of the delay depends on cooperation between both payers and providers.

"ICD-10 is kind of a self-fulfilling prophecy for providers," Newlin said. "Organizations that are not big on ICD-10, and are expecting it to cause them more issues than it solves, won't be able to make the changes they need to if they don't devote the time and resources to something they don't want to do. And if the providers aren't early enough to the game, the payers won't be able to see what technical issues they need to solve in time. So whether it actually happens in 2014 or 2015 or 2016, it really doesn't matter if everyone isn't working together toward the same goal."

Newlin also stressed the importance of an interconnected, communicable workflow to ease whatever troubles organizations may encounter during their delayed preparations. By heading off any issues in the meantime, these potential disruptions can be avoided.

ICD-10 delay and the true costs of implementation
The common criticism of the ICD-10 year-long pushback is aimed at how suspended costs related to preparations in staff member training and software procurement may not be recouped by the organizations that spent them.

For this reason, the Deloitte Center for Health Solutions released a report on industry reactions to the ICD-10 delay. By live-polling more than 1,250 health care industry professionals, Deloitte was able to gain a comprehensive perspective on organizations' various states.

The report found that 58 percent of professionals may be disappointed overall in the decision to delay the original Oct. 1, 2014, transition to the new medical billing codes. A further 49 percent wanted a new deadline definitively set by the CMS or some other agency for Oct. 1, 2015. The original bill only pushed the implementation to at least that date, but later dates may be selected.

There is strict imperative to these opinions as well. Of the respondents to the survey, over 58 percent of professionals indicated that resources and funding will be the more impacted areas of their organizations. An additional 59 percent indicated that they still believe any transition right now would cause a loss of business momentum on their parts.

In these cases, it can benefit practices large and small to find their own strengths and weaknesses when it comes to the delay