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Tuesday, May 12, 2015

Health Care Reform Articles - May 12, 2015

'On Fire While Water Skiing:' Maine Doctors Prepare for Onslaught of New Medical Codes 

  MAY 7, 2015
PORTLAND, Maine - The year 2015 is one some physicians have been dreading. It's the year that medical codes - the descriptions used to document your health history and submit claims - get an upgrade. The current coding system was adopted in 1979 - the same year the "Pina Colada" song came out.
The new coding system will launch in the U.S. this October, and that means health care providers have five months left to cram tens of thousands of new medical descriptions into their heads. Some physicians say the change is a boon to higher quality care. Others say it's a bust. The coding system is called the International Classification of Diseases, or ICD. While the current system - ICD-9 - came out in the 70's, ICD-10 actually came out in the 1990s. Since then, every developed country has adopted it, says Dr. Jackie Cawley, Chief Medical Information Officer at MaineHealth - every one, she says, except for the United States. "As far as we know, we are the last country. We're behind the rest of the world."
There have been previous attempts to adopt it, but every one has been delayed because it's a monumental and costly task. Every health system, every commercial insurer, plus Medicare and Medicaid, need to swap out one information system for another.
Then there's the training: ICD 9 has about 17,000 codes, says Cawley. ICD-10 has 140,000 - eight times as many. There's a code to describe nearly any medical scenario you can imagine.
Dr. Jackie Cawley: "Um, 'on fire while water skiing.' I thought that was kind of a neat one."

High prices for drugs to treat rare diseases take a toll

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One girl’s hope, a nation’s dilemma

The Cambridge firm’s drug worked wonders, but was hugely costly — more than Costa Rica thought it could spend on one child among millions

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