Time to take another look at the politics of ICD-10

Carl Natale
by Carl Natale

I doubt President Obama will mention ICD-10 coding in his state of the union speech tonight. 

But maybe he will give a nod to Marilyn Tavenner, the acting administrator of the Centers for Medicare and Medicaid Services (CMS). After all, he re-nominated her to lead CMS without the word "acting" in the title. She was nominated 14 months ago, but the U.S. Senate never scheduled her confirmation hearing.

There is a lot of support for Tavenner in the healthcare industry — even the AMA supports Tavenner's nomination. But don't expect her to appearing in a Senate confirmation hearing soon. It is doubtful that Tavenner will get a confirmation hearing.

[See also: Political Analysis: Washington has bigger fights than the ICD-10 debate]

Speaking of futile political efforts

Health Information and Management Systems Society (HIMSS) sent a  letter supporting the ICD-10 timeline to Health and Human Services (HHS) Secretary Kathleen Sebelius and  Tavenner. It's not exactly canceling the letter that the AMA sent in December. There are bigger concerns at work.

For example, the HIMSS letter has some interesting arguments regarding enhancing patient care, waste reduction and actionable data. But this is probably the most compelling:

"By all accounts, further delay in implementing ICD-10 will result in billions of dollars in lost investment for those who have been preparing for ICD-10 nationwide implementation, and the eventual upgrading of the nation’s medical coding standard will cost billions of dollars more the longer we wait"

 I know that American physicians complaining about bureaucratic burdens and $83,000 price tags could play well with individual politicians. But I don't see it adding up to the billions in sunk costs that HIMSS is predicting.

So expect Tavenner to continue to act as administrator of CMS as it keeps ICD-10 implementation on track. The real question will be whether physicians get any financial incentives to vigorously pursue ICD-10 compliance.