No delays for ICD-10, says Tavenner at HIMSS 2014

There will be no more delays to the October 1 deadline to implement the International Classification of Diseases-10th revision (ICD-10) coding system.

That was the message from Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner during Thursday’s keynote presentation to the Health Information and Management Systems Society (HIMSS) 2014 Annual Conference and Exhibition in Orlando, Florida.

Tavenner made the remarks to thousands of attendees during the Thursday morning session, addressing a range of topics from fee-for-service to the progress made following last fall’s faulty rollout of HealthCare.gov.

In addressing the ICD-10 implementation timeline, Tavenner says, “Let’s face it, we have delayed this more than once, and it is time to move on. We have already delayed the adoption standard, a standard the rest of the world has adopted many years ago, and we have delayed it several times, most recently last year. There will be no change in the deadline for ICD-10.”

Earlier this month, the American Medical Association (AMA) petitioned CMS for a delay in ICD-10, due to financial and administrative costs that they say medical practices aren’t ready for. According to the AMA, small practices can expect costs ranging from $56,639 to $226,105 to implement ICD-10. According to a February survey by the Medical Management Group Association, 79% of physicians report that they haven’t begun ICD-10 implementation, or were only “somewhat ready.”

Despite media reports questioning whether electronic health records (EHR) vendors and public and commercial payers will even be ready for the ICD-10 conversion, Tavenner says CMS will be.

In 2011, CMS began installing and testing system changes to support ICD-10, Tavenner says. As of October 2013, the service systems at CMS were ready and a range of testing will ensue. CMS is conducting a Medicare testing period from March 3 to March 7 so that providers, billing companies, and clearinghouses can determine whether CMS will accept their claims under ICD-10.

Also in March, CMS plans to solicit 500 volunteers to participate in end-to-end testing of more than 25,000 test claims to evaluate the government’s payment system.

While ICD-10 is an important market change, it’s one of five key trends impacting physicians this year. Some of the other challenges include:

EHR interoperability

-Tavenner spoke about the vision and promise of making EHR systems truly interoperable.

“Data is the lifeblood of our healthcare system, and for too long it has not been optimized by its full potential,” she says.

While 2014 saw the start of CMS’ Meaningful Use Stage 2 (MU2) program, Tavenner estimated that 60% of healthcare professionals and more than 86% of hospitals now have qualified for financial incentives for adopting EHR technology.

Tavenner also called on EHR vendors to meet the requirements for MU2 to help providers manage the transition to ICD-10 and improve physician-to-physician communication and population health.

Since 2011, the government has doled out $5.8 billion to eligible providers to adopt and use EHRs. In addition, close to $500 million in incentives have been paid to 78,000 physician practices using the Physician Quality Reporting System and e-prescribing programs, she says.

Rocky rollout of healthcare.gov

-The end of the Affordable Care Act’s (ACA) first enrollment period (March 31) after the faulty rollout last fall of HealthCare.gov.

“I love the work we are doing, but we have certainly experienced all of the difficulties related to the challenges of new systems, relationships with vendors and charting the course of previously unnavigated waters,” Tavenner says. “We have made significant progress, and it will help streamline the second open enrollment next fall,” she says.

But the end game was to enroll millions of Americans, and the close of the first enrollment period on March 31 will achieve that.

Paying for quality

-There will be a continued transition from fee-for-service to rewarding providers for quality outcomes and lowering cost. This model will continue to expand over the next five years.

Open disclosure

-The Physician Payments Sunshine Act, which takes effect in October, will disclose financial relationships between physicians and suppliers.

Healthcare is undergoing major reform, Tavenner says, and the promise of healthcare technology will ultimately improve care for patients.

“At CMS, we are experiencing a sea change in the way we think about and safely and securely share data,” Tavenner says. “Big tasks require big commitments. Our goal is simple to say the least: better health, better care, lower cost. We can have a better healthcare system. We deserve the highest quality healthcare system…. And we need to continually strive for a better healthcare system for all Americans.”