Paul Levy: Is ICD-10 Worth the Cost?

Paul Levy, prominent blogger and former president and CEO of Beth Israel Deaconess Medical Center in Boston, has questioned whether ICD-10 is worth the time, effort and cost to providers.

In a post for his blog "Not Running a Hospital," Mr. Levy cites a piece by John Halamka, MD, CIO of BIDMC. In 2011, Mr. Halamka wrote Congress should hold hearings on what payers and providers are spending on the ICD-10 conversion and that the government is creating a reimbursement system that is too complex. "Costs for consulting services alone run into the millions," Mr. Halamka wrote. "This does not count the application software conversion, training and education, and other 'in-house' costs. At our medical center, we would be paying $380,000 according to HHS estimates. Instead, the marginal cost of ICD-10 will be in excess of $5 [million]. For multihospital systems, the costs may exceed $100 [million]."

Nachimson Advisors recently released a revised edition of a 2008 study on the cost of the ICD-10 conversion for physician practices. The original study showed transition costs would range from an estimated $83,290 for a small practice (three physicians) to up to $2.7 million for a large practice (100 physicians). Based on regulatory and industry changes, a revised 2014 edition of the study projects costs at up to three times the 2008 estimates — from between $56,639 and $226,105 for the small practice up to between $2 million to $8 million for the large practice. 

Mr. Levy wrote he doesn't quite understand why ICD-10 and detailed record-keeping of clinical activities is necessary, especially if the U.S. healthcare system is looking to move toward global, or capitated, payments. Additionally, he wrote the new level of detail creates "immense compliance risks" for physicians and hospitals, increasing the odds of accidentally coding something wrong.

Ultimately, Mr. Levy concluded it's better for clinicians to spend time communicating with patients rather than coding: "I'd prefer that providers be allowed to spend more time calling their patients and talking to them about their conditions rather than coding their illnesses."

More Articles on ICD-10:
3 Best Practices for Getting Physicians on Board With ICD-10 Implementation
AAPC: 3 Tips on Selecting Proper ICD-10 Codes
5 Notable Surveys on ICD-10 Readiness 

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