The Centers for Medicare and Medicaid Services (CMS) was busy last week. On Thursday, the agency released the final rules for stage 2 meaningful use. And on Friday, CMS finalized October 1, 2014 as the deadline for ICD-10 compliance. News like this elicits commentary in the media, particularly when an agency extends a deadline. But was CMS listening to the voice of the customer when drafting the final rules and the ICD-10 deadline?
In the case of the stage 2 meaningful use rules, "We believe this change will give covered entities the additional time needed to synchronize system and business process preparation and change over to the updated medical data code sets," CMS said in a 208-page rule published in the Federal Register. Earlier this year, the agency encouraged healthcare stakeholders to submit comments on the proposed rules for Stage 2 of the meaningful use program. The rule outlines the certification criteria that EHR makers must satisfy for their products to meet the program's standards. Medicare and Medicaid providers must satisfy these rules to receive incentive payments.
According to Farzad Mostashari, MD, national coordinator for health IT, “Stage 1 was about beginning of the journey, collecting the data, and beginning toward using decision support. Stage 2 will take time to make the most meaningful use of meaningful use.”
It is hard to judge whether or not this will work, but the rules will help create the right incentives for broader payment and delivery system changes, in the spirit of health reform. As with any change it won’t happen overnight. But the agency is involving its customers—the providers—to help reduce their burden and ensure buy-in.
ICD-10 is short for International Classification of Diseases, 10th Revision. Physicians, hospitals and insurers use the codes to track and manage diagnosis, treatment and payment information. The switch from ICD-9 to ICD-10 code sets will require healthcare providers and insurers to change out about 14,000 codes for about 69,000 codes.
When the agency announced the ICD-10 extension, you could hear a collective sigh of relief across the industry. First off, it eliminates uncertainty, as this has been going on since April, when Department of Health and Human Services Secretary Kathleen Sebelius announced plans to push back the deadline. A hard and fast deadline mintains momentum and the value of work already done. But at that time, many in the industry, including John Halamka, were encouraging a later deadline, “so that the work on the front end [meaningful use] aligns with the work on the back end [of ICD-10]."
Providers have so many compliance responsibilities, in addition to tending to patients. The ICD-10 rule will ultimately help. However, this doesn’t mean people involved with the transition should simply stop planning. More time means just that. It offers an opportunity to get the right people and processes in place so that when it comes time to flip the switch, organizations won’t be scrambling and the transition won’t be drastic.
However, an interesting poll on ICD10Watch asks “Does the one-year extension of ICD-10 implementation give you enough time to comply?” Of the 82 respondents, 17 percent said, “Yes, but we need the extension,” while 5 percent opted for “No, we need two years,” and 5 percent voted “No, we need to wait for ICD-11.” The overwhelmingly most popular answer: 73 percent indicated “Yes, but we would have been ready in 2013.”
I guess that brings out another lesson in listening to the customer, the voice is not only varied, but it also can change at any point in time.
The ICD10Watch survey includes a small sample of customer. The ultimate goal for a deadline like this is to try to get everyone involved at the same place at the same time.
Is the CMS slowing down the inevitable by pushing the deadlines to 2014, or making sure that it accommodates for as many customers as possible to get the most buy-in? Let us know your thoughts.
Posted by Davida Dinerman on August 27, 2012 at 1:21 PM