Marcia Frellick

June 08, 2015

CHICAGO — If the International Classification of Diseases, Tenth Revision (ICD-10) were implemented today, it could mean "a catastrophic disruption to physician practices," according to American Medical Association (AMA) President Robert Wah, MD.

Preliminary testing of the codes, which are scheduled to roll out October 1, has shown that Medicare claims acceptance rates would fall from 97% to 81%, Dr Wah reported here during the opening session of the AMA 2015 Annual Meeting.

And that might be a best-case scenario. "That's 20% failure. And this was among the doctors at the front of the classroom waving their hands to volunteer," he explained.

The AMA will work toward more testing, a grace period to reduce claim denials, and hardship exemptions and authority for advanced payment to head off cash flow trouble.

The ICD-10 battle is one of the many left in the wake of one of physicians' biggest congressional wins in recent history — repeal of the Sustainable Growth Rate formula in April, Dr Wah reported to hearty applause.

The change in codes comes as physicians are still struggling to meet meaningful use guidelines.

The requirements are "a heavy burden and a prison for innovation," he said. Physicians successfully got the federal government to reduce the reporting period from 1 year to 90 days and to ease the patient engagement requirement "for now," Dr Wah said.

The meaningful use stage 2 requirement to provide access to view, download, and transmit health information to a third party for at least 50% of unique patients stands. However, in the proposed rule change for stage 2, physicians only have to demonstrate that one patient has done it.

Some have speculated that in the final rule, that number will be higher.

Before electronic health records can truly enhance care, they must be interoperable, streamline workload and payment, and encourage interaction between physicians and patients, Dr Wah explained.

Abolish Payment Advisory Board

The AMA continues to ask Congress to repeal the Independent Payment Advisory Board, an independent board charged with recommending cuts in payments to Medicare providers when spending exceeds targets. The House Ways and Means Committee approved a bill to repeal the board on June 2.

James Madara, MD, chief executive officer and executive vice president of the AMA, recounted the organization's recent progress in fighting diabetes.

"The sobering fact is that 86 million adults in our country have prediabetes, and 90% don't know it," he said.

 
The sobering fact is that 86 million adults in our country have prediabetes, and 90% don't know it.
 

In 2014, the AMA piloted a program to stop diabetes before it starts. This year, the association partnered with the Centers for Disease Control and Prevention to launch Prevent Diabetes STAT (Screen, Test, Act Today), which is now used in public health departments in all 50 states. The Prevent Diabetes STAT website directs patients, providers, and other stakeholders to take action and offers support on where to find help.

Meanwhile, the association is working on a vision for the medical school of the future. A consortium of 11 medical schools is proposing changes to the traditional experience.

One example is creating core competencies for medical students who want to pursue an informatics path. Another is to create a "medical home" for each student's portfolio that includes elements such as competency-based assessments, experience logs, written reflections, and coach-guided summaries.

"Our consortium students are coming to understand that physicians must lead the conversation to bridge the gap between ideation and the day-to-day realities of patient care," said Dr Madara.

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