Health plan identifier, ICD-10 delay will impact EHRs

The proposed rule released  this week by the U.S. Department of Health & Human Services that would create a new health plan identifier is expected to spur the use of transmissions to and from electronic health records and reduce administrative costs for providers.

"The implementation ... [of the health plan identifier] is expected to streamline HIPAA electronic transactions, make them more consistent, and decrease the dependence on manual intervention in the transmission of health care and payment information," HHS stated in the proposed rule. "This, in turn, will drive more healthcare providers and health plans to utilize electronic transactions in their operations."

The proposed health plan identifier, required by the Affordable Care Act and developed by HHS' Office of E-Health Standards and Services, also will affect the design of EHRs, Wendy Whittington, Chief Medical Officer of Dallas-based Anthelio Healthcare Solutions told FierceEMR.

"This seemed like something that really needed to happen. The more of these changes and additions that are made now and can be smoothly incorporated into our EHR builds, the better," she said.

The proposed rule also creates an identifier for other entities, such as third-party administrators.

The new identifiers will be used to identify plans and other entities in EHRs, health information exchanges, and elsewhere. The effective date of the regulation is stated for Oct. 1, 2012. Most health plans will have to comply by Oct. 1, 2014.

The proposed delay of ICD-10 implementation from Oct. 1, 2013 to Oct. 1, 2014, also announced in the proposed rule, is due in part to EHRs, as providers are stretched to the limit attempting to implement both at the same time. "No provider organization has unlimited resources. CIOs are equally involved in both implementing EHRs and ICD-10," Anwesh Dutta, a manager of PwC's Health Care Information Technology Advisory Practice, told FierceEMR.

The delay will enable providers to automate more effectively. For instance, the diagnosis code for asthma for Meaningful Use will be the same as the one for ICD-10. "The two initiatives are dependent on each other. It's really one initiative," Dutta explained.

To learn more:
- here's the announcement
- read the proposed rule (.pdf)