In the wake of the breaking news early yesterday evening that the U.S. Senate passed another temporary Sustainable Growth Rate (SGR) "doc fix" bill, various industry groups released statements to express their dissatisfaction with the decision.
The Chicago-based American Medical Association (AMA), which has previously been resistant to the ICD-10 transition, is now overwhelmingly against another temporary fix to the SGR. “The AMA is deeply disappointed by the Senate’s decision to enact a 17th patch to fix the flawed sustainable growth rate (SGR) formula,” AMA president Ardis Dee Hoven, M.D., said in a statement following the vote. “Congress has spent more taxpayer money on temporary patches than it would cost to solve the problem for good.”
The $21 billion patch was passed in a vote of 64 to 35, which took place on the eve of an SGR-imposed payment cut of 24 percent. The patch will extend the current 0.5 percent update through the end of the year and freeze payment rates from January to March of next year. The bill is still awaiting approval from President Barack Obama; sources have told Healthcare Informatics he will sign it. “This bill perpetuates an environment of uncertainty for physicians, making it harder for them to implement new innovative systems to better coordinate care and improve quality of care for patients,” Hoven said.
Included in the bill is another one-year delay of implementation of the ICD-10 code set, which would now be pushed back until Oct. 1, 2015, assuming the bill is signed into a law by President Obama. AMA has said that transitioning to the new code set will be extremely costly for physicians, and the group is continuing to work to stop its implementation altogether.
Another healthcare professional association, the Washington, D.C.-based American Health Information Management Association (AHIMA), expressed deep disappointment in the results of yesterday’s vote, 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. This does not include the lost opportunity costs of failing to move to a more effective code set, AHIMA says.
AHIMA also seems to be concerned with included language delaying implementation of the ICD-10 code set until at least October 1, 2015. “On behalf of our more than 72,000 members who have prepared for ICD-10 in good faith, AHIMA will seek immediate clarification on a number of technical issues such as the exact length of the delay,” AHIMA CEO Lynne Thomas Gordon said in a statement. The group’s officials did say that it will continue to help lend technical assistance and training to stakeholders as they are forced to navigate the challenge of continuing to prepare for ICD-10 while still using ICD-9.
The U.S. remains one of the only developed countries that has not made the transition to ICD-10 or a clinical modification, a more modern, robust and precise coding system that is essential to fully realize the benefits of the investments in electronic health records (EHRs) and maximize health information exchange (HIE). The delay casts a cloud on the employment prospects of more than 25,000 students who have learned to code exclusively in ICD-10 in health information management (HIM) associate and baccalaureate educational programs, AHIMA says.
“As demands for quality healthcare data continue to increase, this delay will add an additional significant hurdle for the healthcare system to fill these important HIM positions,” Thomas Gordon said. “It is truly unfortunate that Congress chose to embed language about delaying ICD-10 into legislation intended to address the need for an SGR fix in their effort to temporarily address the long outstanding and critically important physician payment issues.”
Another industry group, the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), is also in agreement with AMA and AHIMA. In a statement released on its website last night, Russell P. Branzell, CHIME president and CEO, said, “We are extremely disappointed by today’s vote. We understand the considerable hours, resources, and money CHIME members and their organizations have spent preparing for the transition. This pause in momentum discredits the significant work our industry has spent training staff, conducting testing, and converting systems; not to mention the hold on improving care quality and accuracy, advancing clinical reporting and research, and patient safety outcomes.”
Branzell further stated that the Centers for Medicare & Medicaid Services (CMS) must now provide new guidance to the industry on what the delay means for providers, vendors, clearinghouses and other concerned parties. CMS Administrator Marilyn Tavenner, R.N., has previously asserted firmly that CMS and HHS would not consider any further delays in the ICD-10 transition beyond Oct. 1 of this year.
“The delay leaves numerous unanswered questions from testing, training and revamping the agency’s education resources, such as the CMS eHealth University, designed to help providers understand, implement, and successfully participate in the conversion process,” Branzell said. “We will look for information from CMS as it becomes available, and will continue to work diligently with stakeholders to prevent any further delay beyond 2015.”
