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Learn MoreThis blog post is the first of three excerpts from our recent article, “Easing the Burden: Healthcare Providers Are Crying Out for Regulatory Relief. Is the Government Listening?”
“Patient safety and positive outcomes are at the center of what we do.”
That phrase, or one similar to it, could be attached to any marketing or advertising material put out in the healthcare world. Few, if any, providers would take exception. Indeed, patient safety does reside at the core of healthcare, and is ensured not only by professional and well-trained providers and competently run healthcare systems, but it is also safeguarded by a vast number of local, state, and federal regulations.
That’s the area where there is some conflict. The regulatory landscape, particularly at the federal level, has become increasingly cumbersome, conflicted, and difficult to navigate. This burden has resulted in providers and systems saying they are spending too much time ensuring compliance, taking them away from their primary mission of providing care.
The problem has been thoroughly examined and most recently documented in a report from the American Hospital Association: “Regulatory Overload: Assessing the Regulatory Burden of Health Systems, Hospitals and Post-acute Care Providers” (AHA, Regulatory Overload, 2017). In its research, the AHA digs into the tension between providing high-quality care and the agencies charged with governmental oversight, and how those two groups often collide rather than work in tandem.
“Federal regulation is largely intended to ensure that health care patients receive safe, high-quality care. In recent years, however, clinical staff — doctors, nurses and caregivers — find themselves devoting more time to regulatory compliance, taking them away from patient care. Some of these rules do not improve care, and all of them raise costs,” the AHA stated in its report summary. “Patients also are affected through less time with their caregivers, unnecessary hurdles to receiving care, and a growing regulatory morass that fuels higher health care costs.” (AHA, Regulatory Overload, 2017).
Numbers and Costs Tell a Startling Story
The AHA research picked apart the healthcare system to divide it into nine domains:
Within those, it found that health systems, hospitals, and post-acute care providers must comply with 629 discrete regulatory requirements. Those split almost evenly, with 342 oriented toward hospitals and 288 toward the post-acute system. The regulations are promulgated primarily by agencies: the Centers for Medicare & Medicaid Services (CMS), the Office of Inspector General (OIG), the Office for Civil Rights (OCR), and the Office of the National Coordinator for Health Information Technology (ONC). There are other federal agencies, however, who do have regulatory oversight (AHA, Regulatory Overload, 2017).
What does this mean out in the “real world?” A lot of time spent making sure that myriad data is not only tracked but documented and archived in such a way that it can be accessed for verification. That takes time, staff, and money. According to one summary of the report (Burke, 2017):
The AHA called out the frequency and pace of regulatory change as a major issue in compliance. By noting that “as new or updated regulations are issued, a provider must quickly mobilize clinical and non-clinical resources to decipher the regulations and then redesign, test, implement, and communicate new processes throughout the organization,” it showed how increasing regulation causes ongoing upheaval in the clinical setting as compliance is sought and achieved. The report also squared off against Meaningful Use, the rollout of which it says is requiring the average-sized hospital to spend nearly $760,000 annually to meet administrative requirements, as well as $411,000 in related upgrades to systems during that same 12-month period — 2.9 times more than IT investments for any other domain. (AHA, Regulatory Overload, 2017).
Future Installments of this series will cover:
References
AHA, “Regulatory Overload.” (2017, November 03). Retrieved August 2018, from https://www.aha.org/guidesreports/2017-11-03-regulatory-overÂload-report)
Burke, D. (2017, November 03). AHA Report: Healthcare Providers are Being Crushed by Regulatory Burdens. Retrieved August, 2018, from http://wallerhealthcareblog.com/post/171/aha-report-healthcare-providers-are-being-crushed-by-regulatory-burdens/1
CMS, “CMS Finalizes Changes to Empower Patients and Reduce Administrative Burden.” (2018, August 2). Retrieved August, 2018, from https://www.cms.gov/newsroom/press-releases/cms-finalizes-changes-empower-patients-and-reduce-administrative-burden
McCanne, D., MD. (2017, October 27). “The cost of regulatory overload.” Retrieved August, 2018, from http://pnhp.org/blog/2017/10/27/the-cost-of-regulatory-overload/
Marshall, M. (2018, February 7). “How Health Care’s Regulatory Landscape is Shifting in 2018.” Retrieved August, 2018, from https://www.cerner.com/blog/how-health-cares-regulatory-landscape-is-shifting-in-2018
Monica, K. (2018, May 7). CMS Working to Change Status Quo of High Administrative Burden. Retrieved August, 2018, from https://ehrintelligence.com/news/cms-working-to-change-status-quo-of-high-administrative-burden
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View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsUtilize patient access solutions and advanced reimbursement solutions to manage clinical denials and improve your organization’s reimbursement strategy.
View All ReimbursementExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsOur competency development solutions personalize learning for clinicians to bridge the gap between theory and practice for your nurse residents.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing orientation challenges to easily achieve and maintain certification with our emergency and acute care training solutions.
View All ProductsAs a premier provider of healthcare education, we are committed to promoting safer, more successful surgical and sedation outcomes for each and every patient.
View All ProductsOur solutions are designed to cater to the needs of patients, healthcare professionals, and organizations dealing with illnesses or chronic conditions.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validate health outcomes and support provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
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