AHA recommends Trump reduce regulatory burden on hospitals
In revising the Affordable Care Act, the AHA urges the president-elect to make no sudden changes.
The American Hospital Association has asked President-elect Donald Trump to reduce the regulatory burden on hospitals by cancelling Stage 3 of meaningful use, suspending star ratings and continuing the fight against health insurance mergers in a letter sent Wednesday to Trump at Pennsylvania Avenue offices near the White House.
AHA President and CEO Richard Pollack congratulated Trump on being elected the 45th president and asked for help in modernizing healthcare policy, in four pages of recommendations.
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"Reducing the administrative complexity of health care would save billions of dollars annually and would allow providers to spend more time on patients, not paperwork," Pollack said.
Quality reporting requirements are often overlapping or conflicting and fail to focus on improving care, Pollack said.
Specifically Pollack urged the Trump Administration to cancel Stage 3 of the meaningful use program so that hospitals would not be forced to spend large sums of money upgrading their electronic health records, for the sole purpose, he said, of meeting regulatory requirements.
"Suspend the flawed hospital star ratings on the Hospital Compare website, as they are inaccurate and provide misleading information to consumers," Pollack said. "Develop a performance reporting option that allows hospital-aligned physicians to fulfill the Medicare Access and CHIP Reauthorization Act (MACRA) quality reporting requirements based on hospital measures."
[Also: MACRA will move forward largely untouched when Trump steps in, experts say]
The organization representing hospitals said the continuation of value-based models is critically important, but added that these models require a significant upfront investment.
The AHA wants the Trump Administration to expand the definition of advanced alternative payment models to allow more clinicians who partner with hospitals on value-based care to achieve payment incentives under MACRA.
"Advance health IT by supporting the adoption of interoperable EHRs, promoting a more consistent use of IT standards and providing improved testing, certification and transparency about vendor products," Pollack said
In revising the Affordable Care Act, the AHA urges the president-elect to make no sudden changes.
"We urge you to ensure that any repeal of portions of the ACA simultaneously include a replacement plan that continues to provide a mechanism for individuals to obtain affordable insurance coverage," Pollack wrote. "Given that healthcare represents a significant portion of the economy and essential public services, we urge you not to make any abrupt changes that could lead to significant instability for patients, providers, insurers and others."
Increased spending in hospitals is due mainly to increases in the use of services, not hospital prices, Pollack said. To keep prices in line, the AHA asked the new administration to address escalating drug prices, to support generic alternatives, and to protect the 340B drug pricing program, which allows hospitals to reduce the price of expensive outpatient drugs.
To protect consumers from excessive financial burden, the AHA recommended combining Medicare Parts A and B. It also suggested limiting Medigap coverage, further means-testing of Medicare premiums and raising the Medicare eligibility age.
Pollack said health insurance mergers such as the mega-mergers being proposed between Anthem and Cigna, and Aetna and Humana, would be harmful for consumers and providers, and urged the administration to continue to challenge these deals.
The AHA asked for a rejection of site neutral payment cuts, which it said prevents hospitals from modernizing facilities.
Pollack asked for the removal of payment barriers to telehealth and remote patient monitoring.
Hospitals want the federal government to waive the skilled nursing three-day stay rule, telehealth restrictions and the prospective beneficiary assignment from all accountable care organization models.
The AHA wants continued funding for the Children's Health Insurance Program, improved access to mental health services by increasing funding for behavioral health services and having policies that integrate mental and physical health.
The AHA wants mental health barriers removed and amending the medicaid Institution for Mental Disease exclusion, eliminating the Medicare 190-day lifetime limit on inpatient psychiatric treatment and provide funding to implement the Comprehensive Addiction and Recovery Act to stop the opioid crisis.
It urged Congress to remove impediments preventing veterans from using the Veterans Choice Program and to make the program permanent.
The AHA recommends revising the recovery auditor contractor contracts to incorporate a financial penalty for high rates of incorrect denials that lead to unnecessary appeals. There's a backlog of claims awaiting adjudication, Pollack said.
Hospitals want a softening of Stark law provisions that prevent physicians from recommending hospitals for care.
They want an elimination of the 25 percent rule for long-term care hospitals and a cap on medical liability.
Modify the current readmissions policy to include sociodemographic adjustment so that providers aren't penalized for factors outside of their control, Pollack said.
Also, the AHA wants to stop what it called federal agency intrusion into private sector accrediting body standards and survey processes.
The AHA wants a rejection of reduction in Medicare funding for graduate medical education.
On Tuesday, the AHA praised the appointment of orthopedic surgeon and Representative Tom Price, R-Georgia to lead the Health and Human Services Department.
Twitter: @SusanJMorse
