In the past, under fee-for service reimbursement, there was very seldom an incentive to being a first mover on new technologies and operational techniques—even if the government set a deadline. When everyone got paid essentially the same for performing healthcare procedures, whether you mailed in your billing or submitted it electronically, a large number of hospitals just goldbricked the deadline as long as they could, knowing it was likely to be extended.
Meeting the deadline just meant you spent your capital dollars in making the conversion—such as is necessary with ICD-10—early. In the old days, all providers would have had to be dragged kicking and screaming into a new operational paradigm.
This time you have big groups complaining vociferously about the delay. I'm talking about HIMSS, as well as hospitals and health systems that decided to lay out the cash and experience the disruption necessary for implementing ICD-10 by the original deadline.
Though it's unusual to have the majority of healthcare bemoaning a deadline extension, the delay itself is nothing different than what has happened ad nauseum since I've been covering healthcare.
The government sets a deadline, bleats on and on about the penalties for missing it, then when the heat gets turned up as the deadline approaches, moves it back. There are legitimate reasons for doing this in all cases. But when it happens every time, providers start to ignore the deadlines, anticipating the delay, as a very vocal bunch clearly has with ICD-10.
What does the government want? No one seems to know. It's running a race, but the rules are ever-malleable. The finish line keeps getting moved back. Sure, there are arbitrary deadlines, but they're often shoved aside because of political considerations.
So what motivates a healthcare provider to invest? To innovate? To move forward?
Certainly not deadlines that have no teeth.