Converting ICD-9 to ICD-10.

Implementing the International Classification of Diseases, Ninth Revision (ICD-9) to International Classification of Diseases, Tenth Revision (ICD-10) conversion on October 1, 2015, in the United States has been a long-term goal. While most countries in the world converted more than 10 years ago, the United States was still using ICD-9. Many countries in the world have a single-payer healthcare system, while there are thousands of different healthcare organizations (providers and payers) that presently exist in the United States. With so many different software platforms for healthcare providers and payers, the conversion had become that much more complicated and capital intensive for all healthcare organizations in the country. A few of the present delay reasons to the ICD-10 conversion in past years were the concurrent timelines for meeting meaningful use requirements for the electronic health record, testing with external payers and upgrades from vendors which added complexities and extra costs. The authors examine the reasoning behind the conversion as well as the delays, before making the conversion on October 1, 2015, and review the question regarding whether the government's decision to push the date back a year would have been helpful.

Bundled payment.

Bundled payment (BP) is defined as a single aggregate payment for all health care services for clinically defined episodes of care. Some results suggest that transitioning from a fee-for-service model to BP resulted in a <10% decline in spending and a 5% to 15% decrease in the utilization of services in the bundle. However, future BPs will need to account for how individual providers will be compensated for their services, and acceptance of BP as a viable health care payment model will depend on the ability of payers and providers to collaborate in a new way to address several operational and implementation challenges.