Use carrots to get ICD-10 compliance

I've written before about the federally supported health information technology regional extension center program established by the American Recovery and Reinvestment Act to help providers adopt and meaningfully use electronic health records systems.

Regular readers already know I'm an unabashed REC fan.

And while we can't foresee all the future benefits of a permanent, robust, well-funded, nationwide health IT extension program, the American Health Information Management Association recently–inadvertently—highlighted one area in which the RECs could pull double duty to the national benefit.

In a recent public comment letter (PDF), the AHIMA chided HHS about extending the compliance deadline to Oct. 1, 2014 for adoption of the International Classification of Diseases 10th Revision code sets. As the AHIMA ruefully points out, many members of the healthcare community squandered the three years HHS gave them for the ICD-10 upgrade.

The AHIMA urged HHS to continue to help healthcare players implement ICD-10, but sagely predicted that “more time, by itself,” is unlikely to ensure all the laggards will meet even the new, extended deadline on time.

In short, HHS must do even more.

“Expanded outreach and education are clearly needed to ensure all industry sectors are able to meet the final compliance date,” AHIMA said.

I agree with the AHIMA on most of this, but take issue with its proposed solution.

The AHIMA said the feds “should work with the private sector to identify the barriers . . . and provide solutions to ensure all sectors are prepared” for ICD-10 compliance by Oct. 1, 2014. To me, that's magical thinking.

Lord knows, there are plenty of HIT vendors and consultants around, so why haven't they seized this ICD-10 market “opportunity?”

The reason, of course, is the ICD-10 laggards, a preponderance of which are smaller hospitals, rural hospitals and smaller office-based physician practices, do need the AHIMA's expanded outreach, but don't have the scratch to avail themselves of outside help at market prices. If market forces ever were going to solve the decades old ICD-10 upgrade problem, they'd have done it by now.

I posit that an appropriate role for government is to do those things that society needs but the market can't produce more efficiently. Thus, supporting the ICD-10 upgrade is a task tailor-made for the RECs.

HHS should add national ICD-10 compliance to the RECs' task list, then ask Congress to create an incentive program to get the job done.

Instead of one common ICD-10 deadline, let's run the country for a while on a dual, ICD-9/ICD-10 coding system. Pay incentives to organizations when they reach ICD-10 compliance and pay the RECs for each organization they help become compliant.

Start working on my idea today and we could get to ICD-10 compliance even before Oct. 1, 2014. Don't do it, and we may never get there.

By the way, the public comment period on the proposed rule to extend the ICD-10 deadline closes at 5 p.m. ET May 17.

You can follow Joseph Conn on Twitter: @MHjconn.