Healthcare News & Insights

AHA: How feds must reduce burdensome regs for hospitals

Hospitals face many regulatory burdens they must juggle to survive in the current healthcare climate. To lighten the load, the American Hospital Association (AHA) is asking the feds to make changes that would make life easier for facilities. 

The AHA has submitted a response to a request for comments solicited by the Centers for Medicare & Medicaid Services (CMS). CMS wanted feedback from providers, hospitals and other stakeholders on ways to make its policies more flexible and efficient.

Suggestions for improvement

Based on past feedback, CMS has already made several changes to existing regulations, including postponing the widespread adoption of additional bundled payment models and expanding the meaningful use reporting period to 90 days for FY 2018.

However, the AHA said in its letter to CMS, more work needs to be done. Here are some of the organization’s suggestions:

  • Cancel Stage 3 of the meaningful use program. Stage 3 of meaningful use will require many hospitals to upgrade their electronic health records (EHR) systems to meet more stringent requirements. Although CMS has said in the past that it was revamping its meaningful use program to be more patient-centered, administrative burdens remain. The AHA said CMS can make the program better by removing Stage 3, allowing the 90-day reporting period for each remaining year and getting rid of the “all-or-nothing approach” that it’s used to determine whether hospitals succeed.
  • Remove the star ratings from the Hospital Compare website. Ever since CMS started publishing hospital star ratings on its website, ranking hospitals based on performance and quality metrics, the practice has been controversial. Opponents say the ratings don’t paint a full picture of a hospital’s care, and they can be misleading to patients since the methodology is flawed. Because of this, the AHA wants the organization to stop using star ratings to rank hospitals.
  • Suspend electronic quality reporting requirements. Quality reporting has been a significant part of the shift toward value-based payments, and the AHA says mandates to do so electronically have drastically increased the administrative and financial burden on hospitals. Plus, CMS has acknowledged that initial electronic submissions aren’t fully capturing the quality of care provided to patients. But the agency still wants to increase electronic quality reporting requirements for hospitals over the next two years, so the AHA is asking CMS to reconsider.
  • Only release data that matters. Currently, CMS publishes data on almost 90 measures of hospital quality, along with demographic information on hospitals and Medicare payment data for facilities. And CMS recently proposed that accrediting organizations make the results of all inspections public. All this data amounts to overload for hospitals, healthcare providers and patients. With that in mind, the AHA wants CMS to work with various stakeholders to pare down this information and only release what’s critical to evaluate patient safety and quality of care.
  • Remove faulty quality measures. Quality reporting makes an impact on hospitals’ finances through initiatives such as the readmissions reduction program and value-based purchasing. But measures may not always be accurate, putting facilities at a disadvantage. So the AHA wants CMS to revamp its inpatient quality reporting and outpatient quality reporting programs, getting rid of all measures added to each one on or after Aug. 1, 2014, because many of them conflict and overlap with existing measures.

Besides these key changes, the AHA also wants CMS to postpone and re-evaluate the requirements for post-acute care quality measures, eliminate certain regulations for long-term care hospitals and protect Medicaid disproportionate share hospital (DSH) payments, among other suggestions.

Time will tell if CMS uses this feedback to update proposed rules and regulations, but this can give individual hospitals an idea of potential changes to watch for, and it also offers facilities an opportunity to contact CMS and endorse these suggestions, or offer their own ideas for improvement.

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