A new report released today examines some of the most detrimental legal barriers that hospitals and physicians face whenever they try to work together to transform the delivery of patient care. Unquestionably, these barriers impede the hospital field’s efforts to move from a payment system based on volume to one that rewards value.  That is because the legal framework that controls the ability of hospitals and physicians to work together, and with their patients, is firmly stuck in the past.

The report examines the types of collaborative arrangements between hospitals and physicians and hospitals, physicians and their patients that are being impeded by the Stark and Anti-Kickback Laws and/or regulations and proposes solutions to foster and protect those efforts.  Common-sense “safe harbors” would be created under the Anti-Kickback Law and reforms to the Stark Law would refocus it on physician ownership, its original purpose, which means that compensation would be regulated exclusively under the Anti-Kickback Law.  

The new payment models being promoted by policymakers and embraced by the hospital field create accountability for the health of a patient beyond an inpatient admission, an outpatient procedure or an office visit – a responsibility that requires hospitals, physicians and other health care providers and professionals to work as a team and with the patients they care for.  Common goals, aligned incentives and a regulatory structure that supports rather than impedes those efforts are essential to success. 

 

The Regulatory Barriers that Most Need to be Tackled Now:

  1. Impractical limits on sharing electronic health records and analysis tools needed to improve and coordinate care.
  2. Disincentives to redesign care and improve outcomes for patients.
  3. Disincentives to employ more effective and efficient treatment options.
  4. Roadblocks to rewarding a team-based approach that includes non-physician practitioners.
  5. Roadblocks to coordinating care for patients when they leave the hospital.
  6. Restrictions on assisting a patient with discharge planning.
  7. Restrictions on providing assistance to patients to help them recover after they leave the hospital.