The Impact of Financial Incentives on ICD-10 Debate


ICD 10 ImpactICD stands for International Classification of Diseases and its codes hold important information with respect to managing health and treating conditions. The healthcare system in USA relies on a set of codes known as ICD-9 to document diagnosis and in patient procedures. These codes were introduced in the late 1970’s and will be replaced soon by a new set of more detailed ICD-10 codes. The deadline for this transition is October 01, 2015. Changing over to the new set of ICD-10 codes will have a significant financial impact across the healthcare industry. There are multiple studies for estimating the initial cost of the implementation and they also estimate the savings and profits, which amounts to millions of dollars. This estimate should not be overlooked by the medical billers and coders.

There is a big debate among the healthcare industry experts in favor of and against the switch to ICD-10 codes. The argument brewing against it is that the financial impact to medical practices as a result of this switch is very high and this is causing a delay in the process. Keeping this in mind, the experts are of the opinion that a huge initiative such as this deserves an incentive; however, there is none. Furthermore, physicians face a counter incentive which is: practices will not get paid if they don’t use the ICD-10 codes.

Many healthcare professionals feel that the federal government should provide financial assistance, and especially so to the small and individual practices. The other view point says, to bring about this change in the industry standards the government needs not fund as it would lead to the danger of bankruptcy in the healthcare industry.

There are many factors in the ICD-10 switch that are beneficial to the physicians. An effort from the federal government to educate the physicians about these benefits could have mitigated this debate, since the benefits would have encouraged the physicians to voluntarily make the switch.

Worries of the healthcare industry do not end with just the financial implications of ICD-10. There are other factors like operational hassles, time spent on training, impact on payment policies which will be a part & parcel of the business post the transition. Others are worried about the newer revenue models that pose to be a greater threat to the healthcare industry than the ICD-10 transition.

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