Now What?

I really do not understand how Congress “works.” While it busied itself with passing a law that fails to fix the clearly broken “sustainable growth rate” formula for Medicare physician payments, it added in a surprise for the entire healthcare industry: a provision that mandates a delay in the adoption of ICD-10 by CMS.

According to Modern Healthcare, it is not even clear which lawmaker added it to the bill.

It is no secret that several organizations, including the AMA strongly opposed the planned October 1, 2014 implementation date. I was always ambivalent about ICD-10, for reasons that I have previously shared but this delay seems like very bad public policy to me, for the following reasons:

  1. It punishes the prepared who have hired and trained new coders, invested in new information systems and educated clinicians. The delay basically blows up work plans for a host of activities and leaves providers and payers in a bind – they can’t move forward, but they can’t easily suspend many of these activities either
  2. It creates uncertainty, which in many ways is the worst public policy. With every delay (this is just the latest of many) comes increased skepticism that the next deadline is “for real.” That, in turn, makes planning and preparing even harder
  3. The move to delay was a rider on a bill about something else. There was no transparency about who added it or why, and no opportunity for legislators to evaluate it on its merits. Not what I would call good government

So, now what? I have no idea.

What do you think?


2 thoughts on “Now What?

  1. Perhaps just another example of ” too many cooks” (i.e. pressure from special interests).
    It does add to the chaos and uncertainty of the whole process. Punishing the responsible (who are in my view part of the solution) and rewarding the irresponsible (part of the problem).
    “now what?” kinda sums it up.

  2. I think that the main pressure was from the Democratic party, which is worried about losing senate seats in the upcoming. I asked an AF medical corps colonel if he thought that Obama was mentally ill. He said, “No, he’s just doing the job that he was paid to do.”
    The Democrats are scared and are grasping at straws-Congress often will work with a strong leader, but it will fall apart without leadership. Several historians have compared this to presidential leadership and the ability of congress to care for the country for decades after the American Civil War.

    IDC-10 is another version of the Keystone pipe line. Obama campaigned for conservation–No matter how you feel about it-some days the keystone people are thinking that they can move forward to finishing the project- then the next month they are told to stop-as another government agency needs to reassess Keystone.

    We have a Flip-Flop President and a Do Nothing Congress. They complement each other perfectly.

    Meanwhile the public, business, military, etc don’t know what to do or what to expect. I read some of the letters sent to “The Navy Times” by warship captains, when our flip flop leader told the Syrians not to use chemical weapons. How can any of us figure out what to do?

    I think all of the stated points by the author and other commentators are dead-on.

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