ICD-10 Delay Worries Grow Among Health Leaders

Healthcare executives believe a postponed ICD-10 implementation deadline would disrupt health IT plans and budgets, finds a new poll.
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A new poll of senior healthcare professionals has found that a majority of respondents believe a delay in the ICD-10 compliance deadline won't improve readiness, could harm other health reform efforts, and may have a catastrophic effect on the time, money, and effort that healthcare delivery organizations have already put into meeting the original ICD-10 deadline of October 1, 2013.

The survey, conducted by health IT provider Edifecs, is one of the first surveys to evaluate industry reaction to the U.S. Department of Health & Human Services (HHS) announcement of its intent to postpone the ICD-10 deadline.

The poll was conducted during Edifecs' 2012 ICD-10 Summit, and was taken less than 48 hours after the HHS announcement. The survey asked more than 50 senior healthcare professionals a series of questions to gauge the impact that a delay in the ICD-10 compliance deadline would have on their ICD-10 transition plans, budgets, and progress.

"It is our understanding that HHS is considering different options. That said, the uncertainty is the most unsettling aspect of the situation," Kristine Weinberger, Edifecs' senior healthcare business consultant, told InformationWeek Healthcare. "Until the industry knows the ultimate deadline for ICD-10, many organizations will freeze their budgets, redeploy headcount, and stall the progress that's been made to date. The best thing HHS can do is to make a decision very quickly. The longer the uncertainty continues, the more momentum will be lost."

[ ICD-10 was a hot topic at HIMSS, the most important live event in health IT. See our complete coverage on our HIMSS Special Report page. ]

In recent weeks, organizations like the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS) have expressed their opposition to HHS' decision to delay the ICD-10 deadline, saying it creates uncertainty and will stall the progress health delivery organizations have made in their efforts to achieve ICD-10 implementation.

Among the key findings of the survey:

-- 64% of respondents said a delay would not result in improved readiness, but instead organizations will slow down implementation so the resources (budget and personnel) can be redeployed to other, more urgent initiatives.

-- 76% believe an ICD-10 delay will negatively impact other healthcare reform efforts. According to respondents, ICD-10 creates more specific data that can, in turn, be more effectively analyzed to create better health outcomes. Therefore, tying it to electronic health records now, rather than later, is beneficial to payers, providers, and patients and would avoid rework later.

-- 85% of respondents believe a shift in the compliance date should not exceed one year. A delay of longer than a year will likely freeze budgets, slow down schedules, or stop work altogether. A two-year delay would be either potentially catastrophic or unrecoverable, say 69%.

-- More than half of respondents (59%) believe the date should be moved out for all covered entities, versus mandating different compliance dates for different types of entities. Multiple compliance deadlines would entail significant cost and effort to run both ICD-9 and ICD-10 code sets for the same dates of service.

Weinberger said the respondents are also worried that a delay will create added costs such as maintaining technology resources for an extended period of time.

"By our estimate, a one-year delay would cause a 25% to 30% increase in implementation costs--a figure nearly half of respondents agreed with," Weinberger said. "However, 37% estimated the increase could go as high as 50%. Based on existing estimates of the overall cost to implement ICD-10 industry wide, even our middle-of-the-road estimate of 30% could translate to a cost overrun of more than $4 billion."

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

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