The Transitioning Industry

The healthcare industry is moving at a staggering pace with numerous changes taking place simultaneously. The road ahead lies with a lot of barriers for policy makers, implementers and healthcare service providers.

With the ominous deadline for ICD-10 implementation and Meaningful Use Stage 2, life is not going to be easy for concerned stakeholders.The final date for Meaningful Use Stage 2 and ICD-10 implementation has been extended to October 2014 – giving providers a fresh breath of air before they can plunge into the changes which come along. This extension actually shows the awareness of policy makers regarding the transitioning industry and what problems lie ahead for providers, EMR vendors, insurance companies and patients.

Sue Bowman, director of Coding Policy and Compliance at the American Health Information Management Association agreed with the deadline extension and advocated for the implementation of ICD-10 together with other initiatives such as Electronic Medical Records and Accountable Care Organizations because “they all relate together.” She adds. “To separate them out and say ‘this piece doesn’t need to be done now’ is somewhat shortsighted, they all link together and are interrelated in a way to promote value for healthcare both to improve the quality and costs. I don’t think we are going to see the anticipated benefits of all of the other initiatives unless we move to a better coding system.”

Mr. Ed Hock, a Senior Director at the Advisory Board Committee sheds some light on the importance of clinical documentations required by physicians and how specific they have to be in their diagnoses andsays, “The reality is ICD-10 will require physicians to document things they’ve never had to document before, if they don’t start documenting these new concepts, three things will happen: A claim will be coded lower than it should have and will be reimbursed less than it should have; the claim can be submitted and billed but eventually will be denied; or you don’t end up billing it and query the physicians, which is fine, but it slows down the process significantly.”

It does not end here though; the Healthcare community has to work diligently to put into practice stage 2 of the Meaningful Use program. Providers who want to be eligible for financial incentives under the Meaningful Use program have to apply specific measures and meet objectives to qualify. These objectives range from incorporating clinical lab-test results into Certified EHR Technology as structured data, generate lists of patients by specific conditions to use for quality improvement and reduction of disparities, research, or outreach. Eligible professionals have a different set of objectives than the eligible Hospitals and Critical Access Hospitals.

It is evident that as soon as the stakeholders in the healthcare industry realize the importance of the looming transitions and start working on implementing the changes, the better it will be. Those who neglect the changes will have to live in an era where every stakeholder will be operating a standardized system such as an EMR, where every process will be done electronically by every entity involved – and the ones who still operate on the previous system will eventually be alienated by their own industry.

Farzad Mostashari, the National Coordinator for Health Information Technology voiced similar concerns by saying that pushing the implementation of Meaningful Use would actually segregate the stakeholders in the industry and “both the vendor and provider communities must be given enough time to implement it successfully”.


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