One of the major arguments against the ICD-10 transition are the financial costs to medical practices. Sure, there are accusations of bureaucratic overreach and preventing physicians from spending time treating patients, but the anti-ICD-10 argument is primarily financial.
So why not offer providers an incentive? Take the example of Meaningful Use. If the same physicians opposing ICD-10 can demonstrate Meaningful Use with electronic health records, they can earn extra revenue. Although the money isn’t enough to completely offset the cost of an EHR system, there is some recognition that a new initiative that deserves an incentive.
But there is no such incentive to convert to ICD-10 coding. Instead, there is a counter-incentive, a stick: if a medical practice doesn’t use ICD-10 codes, they won’t get paid.
Who can blame physicians who resent the “all stick, no carrot” approach? Would the American Medical Association be so vigorously opposed if they could get docs some sort of contribution to offset the cost of ICD-10 implementation?
“My thinking about financial support does not turn around support of the AMA per se,” wrote Julie Chicoine, an attorney at The Ohio State University, in an ICD10Watch discussion on LinkedIn. “As much as the fact that this is the third delay and if the industry wants this goal accomplished, then we need to find out what it would take to get it done.”
“If the federal government truly wants to ensure successful ICD-10 transition, then there must be financial assistance to many of the individual and small physician practices to facilitate their implementing EHR and also ICD-10,” she added.
Michael Miscoe, a healthcare attorney and forensic coder/compliance professional, likes the idea too. “ICD-10 is a big change for them and there will be significant costs relative to training, loss of efficiency and revenue cycle delays,” he wrote. “Since the government is mandating the change for their own benefit, why shouldn’t they provide some assistance if for no other reason than to ensure they achieve the results they want?”
“I’m not sure where the concept that all mandates should be funded came from. Not a general concept in other industries,” countered Joe Nichols, principal at Health Data Consulting. “There is a price of doing business and there has already been substantial funding for Meaningful Use.”
Nichols makes some strong arguments that changing an industry standard doesn’t merit federal funding. Perhaps the strongest point is about actually paying for such a program, “If we pay every one for moving to every new standard and the implementation of those standards, we will bankrupt healthcare even more than it already is.”
Indeed, I can’t see Congress paying providers to transition. After all, the Protecting Access to Medicare Act (PAMA) was needed because Congress couldn’t agree on how to pay for killing the sustainable growth rate (SGR).
“Rather than opposing the implementation of ICD-10, perhaps the AMA should have advocated a positive stance which falls short of paying the implementation costs — which I agree would add a further burden on taxpayers,” wrote Paul Weygandt, vice president of physician services at J. A. Thomas & Associates. “There are many components of the ICD-10 transition and the AMA could have worked with CMS toward a collaborative approach to physician and office staff education for ICD-10 (as an example).”
The reason for such a non-collaborative stance probably had nothing to do with ICD-10 codes themselves. Weygandt says physicians who actually learn ICD-10 coding see the benefits.
In fact, there’s more going on in healthcare than just a new coding standard. There are new revenue models looming that threaten healthcare finances more than paying for ICD-10 compliant systems.