Healthcare industry response to yet another postponement of ICD-10 coding ranges from relief to resentment. Those who haven’t prepared for the radical format transition are exhaling contentedly, while those who have worked furiously to make the deadline are understandably indignant about the delay.

With a stroke of his pen, President Obama authorized yet another implementation deferment to the ICD-10 coding system after the Senate approved the measure as part of the Sustainable Growth Rate “doc fix” legislation on April 1. The ICD-10 delay is a late add-on item to HR 4302, initially drafted to stall a 24 percent Medicare reimbursement cut to physicians for one year.

While there is really no way of knowing how many providers are in a position to make the ICD-10 conversion, forwarding the Oct. 1, 2014 implementation date to next year after several false starts has caught many off guard, including Mike Lovett, executive vice president and general manager of Horsham, Pa.-based NextGen.

“It definitely came as a surprise – everyone I’ve spoken to has said another delay would not happen,” he said. “I’m not sure what happened or how it even got on [legislators'] radar.”

Lovett acknowledges that some providers are behind in gearing up for the ICD-10 shift, but also exudes frustration that his clients now have to hurry up and wait.

“This rewards those who weren’t organized,” he said. “It lets them off the hook.”

To be sure, NextGen and its clients “put a lot of work” into getting ready and the delay “only clouds over what has to happen,” Lovett said. “Now we’re looking at spending more on education.”

The EHR Association's comment was neutral regarding the ICD-10 delay, focusing instead on the SGR fix.

"Vendors have been working to support our clients, including providers, hospitals, ACOs and other stakeholders, through the transition to ICD-10," said EHR Association Chair Mickey McGlynn, of Siemens.  "The EHR Association is concerned that this proposed legislation further delays a permanent fix to the SGR formula payment system, which we view as integral to moving toward a value-based payment system."

'Unfortunate’ situation
Watertown, Mass.-based athenahealth is also dismayed at the delay, with Ed Park executive vice president and COO calling it an “unfortunate” situation.

“It is alarmingly clear that healthcare is operating in an environment where there is no penalty for not being able to keep pace with necessary steps and deadlines to move the industry forward,” he said. “Our system is already woefully behind in embracing technology to drive information quality, data exchange and efficiency, and delays like this only hinder us further.”

Park sees instability within the provider sector regarding ICD-10 and calls legislators’ actions “a significant distraction to providers and inappropriately invokes massive additional investments of time and money for all. The issue is even more serious when considered in association with another short-term SGR fix and 2013’s meaningful use Stage 2 delay.”

Chris Powell, president of Wayne, Pa.-based Precyse also sees the postponement as a negative.

“We are disappointed as our clients have spent considerable time and resources ensuring preparedness for Oct. 1, 2014,” he said.

Even so, Powell said the decision strengthens his resolve to continue on the course of helping providers position themselves for the transition when it finally comes.

“This change cannot deter us from our goals to improve the overall level of clinical documentation that will in turn improve the quality of the data and drive delivery of the best healthcare in the world,” he said.

‘Breathing room’
Though these latest developments may cause consternation among those who dutifully followed preparation protocols, there is no doubt that others will appreciate the extra time, says Mike Nolte, COO of Atlanta-based MedAssets.

“A one-year delay provides welcome breathing room for some organizations coping with ongoing financial pressures and concurrent 2014 regulatory mandates, including complying with provisions of the Affordable Care Act and attestation for Stage 2 meaningful ose,” he said. “Our position is that adoption of ICD-10 remains a question of ‘when’ not ‘if.’ And we encourage our clients to proceed with plans and preparations in full force.”