Cost of delay nearly three times the cost of the switch?

The Centers for Medicare and Medicaid Services estimates (warning: PDF) that delaying the switch to ICD-10 will cost as much $6.85 billion.  However, its original maximum estimate (see page 3361, warning: PDF) for the entire switch itself was $2.3 billion.

So we're supposed to believe that a one-year delay will quadruple the cost of the switch?  When CMS wants to switch to ICD-10, it's a mere $2.3 billion, but when CMS gets mad about a Congressionally mandated delay, suddenly the delay all by itself costs $6.85 billion?

CMS estimates low when it wants to do something, and high when it does not want to do something. How petty.

President signs bill delaying switch, now it's the law

President Obama signed H.R. 4302 into law on April 1.  Thus the switch to ICD-10 is officially delayed to October 1, 2015.

Bill delaying switch passes Senate, now goes to President

Today the Senate passed without change a bill that delays the switch to ICD-10 by one year, to October 1, 2015.  It's looking better and better for at least one year of relief from the switch.

Senate to vote on bill that delays the switch

After the House of Representatives approved H.R. 4302 which delays the switch to ICD-10 for one year, to Oct 1, 2015, the Senate is set to vote on the bill on Monday 3/31 at 5:30 pm.

The specific language says: The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for code sets...

A delay would be good.  Canceling the switch altogether would be better.

House bill would delay the switch

A recently introduced bill in the U.S. House of Representatives would delay the switch to ICD-10 until October 1, 2015 (instead of the currently mandated October 1, 2014).  Section 212 of the bill states “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard”.

This language is part of a larger bill that would adjust how Medicare pays doctors, something that Congress has passed every year since 1997.  The bill is expected to pass easily in both the House and Senate and go to the President for signature.

There could be relief from the switch, albeit temporary.

Community and critical access hospitals are likely ICD-10 losers

A recent analysis suggests that your local, community hospital is an "ICD-10 loser".  Fitch Ratings released a report that concludes that expected payment delays with the switch will overwhelm smaller hospitals with minimal cash reserves with which to weather such delays.

Many rural, community hospitals are critical access hospitals.  A critical access hospital is a hospital that is 35 miles or more from the nearest, other hospital and that has been certified by Medicare to receive full-cost reimbursement.  The rationale for improving the financial condition of these hospitals is the recognition of the essential role they play in delivering health care to rural populations.  These hospitals are typically small hospitals with fewer than 50 beds.

Yet, the switch to ICD-10 stands to overwhelm many of them.  Your local, community hospital (which for many of you is a critical access hospital) cannot afford the switch.  Let's stop the switch!

Study: Information loss will occur as a result of the switch to ICD-10

Researchers at the University of Illinois Chicago (UIC) have found that the switch to ICD-10 will result in information loss, which they deem will be significant.

This scientific result blows up the myth that the switch to ICD-10 will uniformly result in better and more information because of an increase in diagnostic precision (which is called "specificity" by proponents of the switch).

The researchers studied hematology and oncology ICD codes, which proponents of the switch have identified as the specialty that will be least affected by the switch.  The information loss affected 8% of total Medicaid codes and 1% of University of Illinois Cancer Center (UICC) codes, affected 2.9% of all Medicaid claims and 5.3% of UICC billing charges.

Although these numbers are seemingly small, according to the researchers, this level of information loss has the potential to "evaporate" the operating margin of a hematology/oncology practice.

So the medical specialty least affected by the switch could see its operating margins evaporate overnight from September 30 to October 1, 2014?

We should not switch to ICD-10.