The ICD-10 delay: Don’t squander the chance to get strategic
By Becky Quammen
A collective sigh of relief could be heard around the healthcare industry when Congress recently voted to extend the deadline for the transition from ICD-9 to ICD-10 from Oct. 1, 2014, to Oct. 1, 2015. However, leaders will be making a big mistake if they collectively decide to put their feet up and relax for any extended period of time. We all know how quickly these deadlines can creep up on us – as this most recent delay represents the third time that the transition to ICD-10 (a coding system that has been widely adopted by other countries) has been put off.
Instead of relaxing, leaders need to get busy now. Fortunately, they can do so with a renewed sense of strategic purpose. Instead of merely checking things off a long to-do list, leaders now can turn the transition to ICD-10 into an opportunity to create a clinically driven revenue cycle, instead of a cumbersome chore that needs to get done to avoid government penalties.
Here’s how: With the one-year extension in place, healthcare leaders should turn their immediate attention to implementing 2014 Edition software in an effort to meet Meaningful Use requirements. To qualify for incentives under the Stage 2 requirements, eligible professionals must meet 17 core objectives and three menu objectives that they select from a total list of six (or a total of 20 core objectives), while eligible hospitals must meet 16 core objectives and three menu objectives that they select from a total list of six (or a total of 19 core objectives).
With the ICD-10 burden delayed, though, it will be much easier to get into the Meaningful Use zone, so to speak. Vendors now have more time to get clinical systems up to speed and tested, and provider organizations have more time to implement these systems – while also training users to fully leverage the more advanced functionality.
The good news is that when organizational leaders turn their attention back to the transition to ICD-10, the transformation will make more sense – as the clinical systems will be ready to welcome the more complex coding. As a result, instead of merely working to meet some random administrative burden being imposed by the government, this transition to a more complex coding system can come to fruition as it was intended – as a vital component in the quest toward creating a healthcare system that emphasizes improved care at reduced costs.
ICD-10, with its greater complexity and granularity, will enable organizations to apply codes more precisely to their clinical actions, making it possible to link payment to care more accurately. With advanced EHRs in place, organizations will be able to integrate the new and improved coding into the care process so that it becomes a by-product of patient care – and not another administrative burden.
If handled correctly, healthcare organizations can not only meet the looming deadline but successfully move their organizations toward clinically driven revenue cycle systems. The value of all this change will become increasingly clear as organizations leverage the creation of a clinically driven revenue cycle to succeed under emerging value-based purchasing programs.
Becky Quammen is CEO of Quammen Health Care Consultants, a full-service consultancy that offers planning, assessment and implementation services that support a wide range of healthcare information system initiatives for providers of all sizes. For more information, go to www.quammengroup.com.
Burwell nominated to replace Sebelius as head of HHS
Kathleen Sebelius, the Secretary of the Department of Health and Human Services who championed the passage and implementation of the Affordable Care Act (ACA), announced her resignation on April 10. President Obama nominated Sylvia Mathews Burwell, Director of the Office of Management and Budget since 2013, to be Sebelius’ replacement.
Sebelius, who was sworn into her position in 2009, had her share of dramatic and controversial ups and downs at the agency, most recently making headlines for the painfully shaky rollout of the HealthCare.gov website, presiding over the ACA insurance program’s milestone of 7.5 million sign-ups on the exchanges and losing her bid to have the ICD-10 coding compliance date stick firmly to October 2014.
Burwell’s notable professional achievements include: President of the Global Development Program of the Bill and Melinda Gates Foundation, President of the Walmart Foundation and Deputy Chief of Staff to President Bill Clinton.
Sylvia Mathews Burwell
“I look forward to carrying on the important work of ensuring that children, families and seniors have the building blocks of healthy and productive lives, whether it’s through implementing the Affordable Care Act, supporting affordable childcare or finding new frontiers to prevent and treat disease,” Burwell said at her official nomination announcement April 11 in the White House Rose Garden.
Big Data and the C-suite
According to a new IBM study, the vast majority of CFOs (82 percent) see the value of integrating enterprise-wide data, but only 24 percent think their team is up to the task. This marks a 205 percent increase in the gap between the importance of data and the ability to exploit its value since the question was first asked in 2005, showcasing a critical divide in the skills and capabilities for today’s finance teams. The study, entitled “Pushing the Frontiers,” is based on findings from face-to-face conversations with 576 CFOs from around the world.
‘Disappointed’ is predominant industry group reaction to ICD-10 delay
After passage of the “doc fix” bill H.R. 4302 (Protecting Access to Medicare Act of 2014) last month, which included a delay of the ICD-10 compliance date to Oct. 1, 2015, at the earliest, reaction by industry groups to putting the brakes on the coding transition was swift and, on the whole, frustrated. While a bit of breathing room was seen as welcome relief for those who have been slow to prepare for the change, heavily invested organizations had reason to cry foul.
“Since the transition to ICD-10 remains inevitable and time sensitive because of the potential risk to public health and the need to track, identify and analyze new clinical services and treatments available for patients, AHIMA 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,” read a statement from the American Health Information Management Association. “It has been estimated 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.”
Reaction from the College of Healthcare Information Management Executives was equally crestfallen. “We are extremely disappointed,” said Russell P. Branzell, FCHIME, CHCIO, President and CEO, CHIME. “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.”
The Healthcare Information and Management Systems Society (HIMSS) kept their response neutral. “We continue to focus our efforts on supporting our stakeholders by providing education, resources and tools to help them make the conversion to ICD-10 in the most effective and efficient ways,” a statement said.
The Workgroup for Electronic Data Interchange highlighted the positive aspects of moving forward. “WEDI believes that the delay in the ICD-10 compliance date will help avoid potential disruptions in the healthcare system by allowing all affected entities more time to complete the necessary work and conduct extensive testing. It is not a reason to pause,” said Devin Jopp, Ed.D., WEDI President and CEO.
At the AMA, the focus was on the “doc fix” part of the legislation, which did not fix anything at all, but rather avoided (for the 17th time in 11 years) a deep cut in Medicare reimbursements to doctors. “The American Medical Association did not support H.R. 4302, since the bill unwisely extended a fiscally irresponsible pattern of congressional procrastination that has perpetuated Medicare’s fatally flawed sustainable growth rate (SGR) formula,” said Ardis Dee Hoven, M.D., President, AMA, in a statement.
“The AMA and other physician organizations strongly agree that while a delay in ICD-10 implementation provides welcomed temporary relief, it does not offset the continued harm caused by keeping the SGR formula on life support and further delaying badly needed Medicare physician payment reforms. The AMA remains committed to relieving physicians of the crushing administrative burdens and practice disruptions that are anticipated during the scheduled transition to ICD-10.”
Neither HHS nor CMS had issued recommendations or even a statement by HMT’s press date.
Can your Wi-Fi network get a virus?
Researchers at the University of Liverpool in England have demonstrated, for the first time ever, that Wi-Fi networks can be infected with a virus – an airborne virus, of course.
In a simulated attack, the clever infector, called Chameleon, was able to avoid detection and identify the points at which Wi-Fi access is least protected by encryption and passwords. And just like a real virus, it spread, traveling across the Wi-Fi network via access points (APs) that connect devices, networking equipment and more – particularly across networks connectable within a 10- to 50-meter radius.
Researchers from the university’s School of Electrical Engineering, Electronics and Computer Science simulated an attack on Belfast and London in a laboratory setting. Chameleon was able to avoid detection because current virus detection systems look for viruses that are present on the Internet or computers, not threats that are present only in the Wi-Fi network.
“When Chameleon attacked an AP, it didn’t affect how it worked, but was able to collect and report the credentials of all other Wi-Fi users who connected to it,” says Alan Marshall, Professor of Network Security at the university. “The virus then sought out other Wi-Fi APs that it could connect to and infect.”
“We demonstrated that this [type of attack] is possible,” says Marshall, “and that it can spread quickly. We are now able to use the data generated from this study to develop a new technique to identify when an attack is likely.”
You can read the full study results, published in the EURASIP Journal on Information Security, by going to here.
HHS releases security risk assessment tool for providers
The Department of Health and Human Services (HHS) has created a new security risk assessment (SRA) tool to help guide healthcare providers in small to medium-size offices conduct risk assessments at their own pace. The SRA tool is the result of a collaborative effort by the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR). The tool is designed to help practices uncover potential weaknesses in their security policies, processes and systems under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. It covers basic security practices, security failures, risk management and personnel issues. Basic security practice questions include: defining and managing access, backups, recoveries, and technical and physical security. The application, available for downloading at www.HealthIT.gov/security-risk-assessment, also produces a report that can be provided to auditors. The tool is available for both Windows operating systems and iOS iPads.