Blog | Friday, May 30, 2014

Now what?


I really do not understand how Congress “works.” While it busied itself with passing a law that fails to fix the clearly broken Sustainable Growth Rate formula for Medicare physician payments, it added in a surprise for the entire health care industry: a provision that mandates a delay in the adoption of ICD-10 by CMS.

According to Modern Healthcare, it is not even clear which lawmaker added it to the bill.

It is no secret that several organizations, including the American Medical Association, strongly opposed the planned Oct. 1, 2014 implementation date. I was always ambivalent about ICD-10, for reasons that I have previously shared, but this delay seems like very bad public policy to me, for the following reasons:
1. It punishes the prepared who have hired and trained new coders, invested in new information systems and educated clinicians. The delay basically blows up work plans for a host of activities and leaves providers and payers in a bind. They can’t move forward, but they can’t easily suspend many of these activities either.
2. It creates uncertainty, which in many ways is the worst public policy. With every delay (this is just the latest of many) comes increased skepticism that the next deadline is “for real.” That, in turn, makes planning and preparing even harder.
3. The move to delay was a rider on a bill about something else. There was no transparency about who added it or why, and no opportunity for legislators to evaluate it on its merits. Not what I would call good government.

So, now what? I have no idea.

What do you think?

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.