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View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreThis blog post is the second of three excerpts from our recent article, “Easing the Burden: Healthcare Providers Are Crying Out for Regulatory Relief. Is the Government Listening?”
Additional costs buried in regulatory oversight include quality reporting, which has been shown to be a costly (per the report, $709,000 a year on administrative aspects) process, thanks to duplication and misalignment in requirement, “many of which require manual data extraction, create inefficiencies and consume significant financial resources and clinical staff time.”
Those issues are joined by fraud and abuse laws such as the Stark Law and the Anti-Kickback Statute, which the report called impediments to transforming care delivery: “While CMS has waived certain fraud and abuse laws for providers participating in various demonstration projects, those who receive a waiver generally cannot apply it beyond the specific demonstration or model. The lack of protections extending care innovations to other Medicare patients or Medicaid and commercially-insured beneficiaries minimizes efficiencies and cost savings realized through these types of models and demonstration projects,” the report states.
Making Regulatory Requirements More Effective
The layout out of these facts and figures is a grim exercise, and the AHA takes care to point out that there are remedies to make regulatory requirements more effective, including but not limited to:
Recommended Solutions from the AHA
The AHA’s recommended solutions, as far as the above items go, are wide in scope and fairly ambitious, as far as what the government should do. Here’s a sampling:
It’s hard to say whether, or when, federal agencies (or their counterparts at the state and local levels) will engage with the AHA’s recommendations. Many Obama-era regulations in other areas are being reduced or repealed by the Trump administration, however, and that has given healthcare industry watchers much to talk and prognosticate about. Like seemingly everything else in healthcare, those opinions vary across the ideological spectrum and often bring in other complex issues such as single-payer healthcare.
Acknowledging the Impact on Outcomes
For instance, Physicians For A National Health Program’s Dr. Don McCanne posited that “A quick look at the nine domains of regulatory overload is all you need to be reminded of the nightmare created by these evolving requirements. Inefficiencies, wasted resources, and provider burnout ensue, which negatively impact the primary mission of the health care system: patient care.” He then goes on to make the case for single payer while also saying that regulatory oversight is still essential. “We desperately need reform, but let’s get it right,” he concluded. (McCanne, 2017).
Interaction with Pay for Performance Models
Elsewhere, Cerner’s Senior Director of Public Policy Meg Marshall took a look at governmental efforts, from late actions by the Obama administration to the Trump team’s attempts at Affordable Care Act repeal and subsequent congressional changes such as eliminating a mandated penalty for not purchasing coverage, as things to watch alongside regulatory change and repeal for beleaguered health systems and providers. On the IT front, for instance, the Cures Act, signed into law in late 2016, provided $10.5 billion to assist providers using electronic health records increase their interoperability. There is related legislation, most notably the Trusted Exchange Framework and Common Agreement, but outcomes overall remain murky due to their relative newness and the voluntary nature of participation in some instances. (Marshall, 2018). Marshall also called out evolutions in payment that will cement a “pay for performance” model for healthcare going forward, rather than the historical bent toward fee-based billing. That also is likely to affect regulatory performance when it comes to privacy oversight and related records handling.
“The days of generating fees-for-service to increase revenue are over,” Marshall says. “With the digitization of electronic health care data, we’re going to continue seeing innovations. That’s going to create some interesting challenges. Data access rights, privacy, and other related policy needs to be addressed to bridge data and business models from non-health care industries. Each industry has grown up with its own expectations around data access, use and agreements. We will probably see some significant changes happen to HIPAA, for example, to accommodate what we need in the health care space.” (Marshall, 2018).
Future Installments of this series will cover:
References
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
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
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 ProductsStandardize policy and procedure management with an automated, customized, and centralized system.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementStreamline the revenue cycle management process and protect your bottom line with expert-backed education.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
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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