Editor's Desk: T.W.I.G. Notes

By Tom Sullivan
08:42 AM

New Year’s predictions are not over just yet – rather they are getting bolder and weightier. Yes, I’m talking about ICD-10, as well as HIEs and ACOs. 

On the first of February, in fact, ONC head Farzad Mostashari told the HIT Policy Committee that even though work remains, “we really do have the pieces coming together for a big win on interoperability in exchange in 2012.” That follows Mostashari’s earlier foundational projection that meaningful use will soar in 2012.

A New York Times editorial predicted this week that health insurance companies will “go the way of the dinosaurs” if they don’t “find a new business to be in,” namely becoming an accountable care organization in one fashion or another. “Here’s a bold prediction for the new year,” the authors wrote in The end of health insurance companies. “By 2012, the American health insurance industry will be extinct.”

With that proclamation, I do believe, they just made "bold" the euphemism of the week. And while this is not intended as a comprehensive counterargument, it is worth pointing out that a Healthcare Finance News poll determined that only 25 percent of readers plan to participate in an ACO, while 41 percent responded that they decidedly do not anticipate becoming part of an ACO, and the remaining 34 percent have yet to figure that out. Over at the HIMSS blog, meanwhile, Justin Barnes, who is co-chair of the Accountable Care Community of Practice (ACCoP), and a vice president at Greenway, the planning-to-IPO today EHR vendor, writes that physicians hold the keys to ACO leadership. “Practices and medical groups should take this to heart, for it is their physicians who are best positioned to lead the way on the understanding of the inter-workings, workflows and care plans that best lead to preventive, coordinated care,” Barnes explained in the post. “And that will translate into properly focused payment structures.”

Presuming, of course, that everything goes according to the federal government’s plans – something that can be said neither of HIPAA 5010 nor of ICD-10 at this point.

Indeed, another side in the ICD-10 war spoke up this week, again firing back at AMA. Responding to AMA’s letter calling on House speaker John Boehner to block the mandate for converting to ICD-10, AHIMA put out a statement titled ‘AHIMA warns: Keep moving on ICD-10 transition.’ And, you know, that’s probably sage advice given CMS’ steadfast stance that the October 1, 2013 deadline is firm.

Even though he advocates holding off on ICD-10 until 2016 or Stage 3 of meaningful use, Dr. John Halamka, standards luminary and CIO of Beth Israel Deaconess Medical Center, on Monday posted two resources for the benefit of other providers embarking down the ICD-10 road. The first is the RFA we used to hire a consulting partner.; the second is the letter BIDMC sent to all stakeholders asking for an inventory list of applications and processes ICD-10 will touch. “ICD-10 is a costly project that will have no benefits and if we're truly successful, the best we can hope for is that no one will be too upset that we implemented it,” Halamka wrote in the post. “Given a project with this many negatives, the least I can do is share everything we're implementing in the hopes that others will benefit from our experience.”

Hmmm… All that does tempt me to add to the 2012 predictions: An industry association war over ICD-10 will break out this year, with others taking up arms to join AHIMA, while AMA will gain its own allies as those who stand to profit from ICD-10 will battle against groups representing the physicians and providers that, ultimately, have to bankroll and implement the new code sets.