AHA leaders say healthcare reform needs fixes

Leaders of the American Hospital Association say the organization supports the new healthcare reform law – but it needs some tweaking.

At the AHA's annual conference Monday in Washington, D.C. – and in preparation for presenting their concerns to Congress on Wednesday – AHA President Rich Umbdenstock said "the political landscape clearly showed that the worst of all options was no reform at all."

Umbdenstock said hospital executives will have a key role to play. "What we do together going forward will decide how well we'll fare," he said.

Reform gives hospitals new options for coping with the inevitable, he said. Prevention is at long last not just rhetoric, he added. Under the Patient Protection and Affordable Care Act, hospitals will have to find ways to deliver care more efficiently at a lower cost, while Medicare fee-for-service will soon become a relic.

"Hospitals will no longer be paid for what they do, but for how much bang for the buck they deliver," Umbdenstock said. "The mantra used to be `do more with less.' This is now changing to 'do better with less.'"

Umbdenstock said some hospitals have already begun "to jump out ahead" in improving value and lowering costs.

The "hospital agenda needs to force healthcare's new reality to catch up with us," he said.

Rick Pollack, executive vice president of the AHA, said the association has several objectives it hopes to convey to Congress on Wednesday.

At the top of the list is the concern about the proposed meaningful use rule, expected out in final form by late spring. The rule requires hospitals to comply with 23 measures to qualify for incentives for the meaningful use of healthcare IT.

The rule is "asking for too much, too soon," Pollack said.

He said it needs to be fixed to provide "a reasonable, phased-in approach" for hospitals to become meaningful users of healthcare IT.

Pollack said the rule should be changed to include all facilities within a hospital system – even if they all share one official provider number. This needs to be changed so that hospitals with multiple campuses are eligible for funding.

The AHA is also calling for changes to how critical access hospitals are paid meaningful use incentives under Medicaid.

According to Pollack, other legislative measures supported by the AHA include:

• a permanent fix to the Medicare physician payment formula, which is scheduled to impose a 21 percent pay cut on June 1;

• extensions to the FMAP funding and COBRA subsidies established under the American Recovery and Reinvestment Act;

• pension funding relief;

• extended Medicare provisions for rural hospitals; and

• changes to the proposed fiscal year 2011 coding offset for the MS-DRG system.