The sheer volume of regulations on the books and the scope of change required in meeting them are outstripping the hospital field’s ability to absorb them. Fortunately, there has been growing recognition of this fact from the Administration and those on Capitol Hill, along with some measurable progress.
The Centers for Medicare & Medicaid Services (CMS) in particular has recently provided important relief to the field, like implementing a 12-month moratorium on the outdated long-term care hospital 25% Rule that prevents patients from getting care in the right place at the right time, calling for a 90-day reporting period – versus a year – to meet the requirements of the meaningful use program for 2018 and making compliance with Stage 3 optional for 2018, and hitting the pause button on the onerous home health pre-claim review demonstration projects, among other examples.
To be sure, the Administration is making headway in addressing the fact that too much of the regulatory morass we deal with is complex, redundant and, in some cases, defies common sense. And yesterday at a stakeholder session hosted by CMS Administrator Seema Verma to formally launch the agency's regulatory relief effort, I thanked her for her leadership in reducing the regulatory burden at an agency-sponsored stakeholder session on how CMS can work with hospitals, health systems and other providers to build on the progress we’ve made so far.
We are for a number of additional steps that can further remove regulatory barriers to better care. They range from aligning quality reporting across all programs and prioritized to focus on “measures that matter” to expanding Medicare coverage of telehealth services that help extend care to patients.
Those recommendations are included in the report we released Wednesday at a Capitol Hill briefing that reinforces our case for regulatory relief and featured Andrew Thomas, M.D., chief medical officer for The Ohio State University Wexner Medical Center; Katie Boston-Leary, president of the Maryland Organization of Nurse Leaders and chief nursing officer at Union Hospital in Elkton, MD; and Mark Hayes, senior vice president of federal policy and advocacy for Ascension. The report found that hospitals and health systems spend $39 billion a year on regulatory requirements affecting non-patient care. That’s about $1,200 every time a patient is admitted to a hospital.
It also found an average-sized community hospital spends nearly $7.6 million annually to support compliance with regulations covering those non-patient care areas. And it dedicates nearly 60 staff members to regulatory compliance – more than one-quarter of which are physicians and nurses.
The burden is simply too heavy – at the expense of patient care.
The men and women who work in America’s hospitals and health systems strive to keep pace with thousands and thousands of pages and rules that govern Medicare and Medicaid. But they are frustrated with a system that often forces them to spend more time pushing paper than treating patients.
Health care is changing. Hospitals and health systems are changing. And regulations that block progress toward meeting patient demands and community expectations must change, too.