If The Patient Protection and Affordable Care Act (PPACA) is repealed it will be interesting to see if it is repealed in whole or in part. The Supreme Court of the United States (SCOTUS) may excise the individual mandate requiring health insurance coverage, or it could strike it down entirely.
The HITECH Act provides incentives for Medicare and Medicaid providers to achieve Meaningful Use of Electronic Medical Records. Meaningful Use Assessment should include these phases and components:
ICD-10 readiness information collected from 2,600 providers, health plans and vendors indicates that the industry would not have been ready on time for ICD-10 according to the Workgroup for Electronic Data Interchange (WEDI).
In the ICD-10 Consortium social network this week, health plans posted questions regarding processing ICD-10 claims that have date of service periods that span the mandated timeline as well as an outreach to other health plans regarding the pros and cons of receiving an ICD-10 claim, mapping it to an ICD-9 to adjudicate it. Also, ICD-10 is expected to impact auto adjudication rates for plans.
One of the key questions will be how the EMR provides a foundation with the Health Information Exchanges (HIEs) for comparative effectiveness data over the life span of a patient (sometimes called the continuum of care) and whether CDA standards currently proposed will accomplish that. Informatics people call this "longitudinal clinical data."
Discussion has been that ICD-10 is a steppingstone to ICD-11, so it is probably a good thing to do.
Look for a balanced approach between EMR vendor, other systems, and an integration strategy that is vendor neutral, enabling all impacted systems to work together to assist in the ICD-10 transition.
Health care providers should ensure that the EMR vendor is on track toward ICD-10 compliance, however they should not rely on their EMR vendor as the panacea. Most hospital systems we work with have many more ancillary systems in radiology, etc. that are also impacted, and the EMR isn't the core system of record (yet) for everything that goes on in a hospital.
Today's Wall Street Journal article on Reverse Mentoring sparked a thought. Healthcare needs reverse mentoring. RM was championed at GE by Jack Welch when he was chief executive. He ordered 500 top-level executives to reach out to people below them to learn how to use the Internet. Mr. Welch was matched with an employee in her 20s who taught him how to surf the Web. The younger mentors "got visibility," he said. For healthcare to change physicians, administrators, IT people and others should reach out to youth.
ICD-10 will re-write the book on diagnosis and procedure coding, utilization pattern history will shift. HIPPS and ICD-10 should not be viewed as separate issues for ICD-10 assessments.
ICD-10 will drive initiatives such as bundling, as a component of health care payment reform. Therefore reimbursement, and case management and other areas must be viewed in a broader landscape. HIPAA mandates and health care reform impact one another.
ICD-10 implementations must move forward despite Presidential campaign promises to repeal 'Omabacare' or the Affordable Care Act. As Business Week pointed out this week, repealing the Accountable Care Act is not that easy. And even if it were repealed ICD-10 is a HIPAA mandate that was enacted prior to President Omaba's election in August 2008. Hospital systems should push ahead on ICD-10 Assessments, ICD-10 Implementation Plans, and get ready for the shift to ICD-10-CM which includes many more diagnosis codes than ICD-9. ICD-10 PCS also include many more procedure codes than ICD-9.