In a recent correspondence with the House Ways and Means Health Subcommittee, the American Hospital Association (AHA) proposed some measures that Congress can take to immediately reduce the regulatory burden on hospitals and healthcare systems.
The AHA believes the regulatory burden on hospitals and health systems is at breaking point and increased regulatory activity is exacerbating the situation.
One example given refers to the Centers for Medicare & Medicaid Services, which in 2016 distributed 49 rules in relation to hospitals and health systems that included almost 2,400 pages. There has also been a rise in sub-regulatory guidance such as FAQs and blogs to assist hospitals and health systems comprehend how to implement administrative policies.
In the correspondence, the AHA states that “In addition to the sheer volume, the scope of changes required by the new regulations is beginning to outstrip the field’s ability to absorb them.”
The AHA has proposed a variety of ways that Congress can take action to immediately lessen the regulatory burden on hospitals, health systems and their patients.
While the proposals cover many areas, there are two possibilities relating to the Health Insurance Portability and Accountability Act (HIPAA) which AHA points out negatively affects patient treatment.
Presently there are obstacles that prevent beneficial sharing of patient health data. For instance, HIPAA Regulations prevent the distribution of patient data for healthcare operations, including the use of data for quality assessment and improvement activities. The restrictions also apply to outcomes evaluation, activities that involve evaluations of provider competence and performance, and to data about patients that have been disclosed to or received by healthcare providers that have or have previously had a patient relationship.
The challenge in an integrated healthcare environment is, in many instances, patients do not have a relationship with all of the healthcare organizations with whom information must be coordinated.
AHA outlines “A clinically integrated setting and each of its participating providers must focus on and be accountable for all patients. Moreover, achieving the meaningful quality and efficiency improvements that a clinically integrated setting promises requires that all participating providers be able to share and conduct population-based data analyses.”
AHA proposes that HIPAA should permit all individuals’ medical data to be disclosed to and used by all participant healthcare providers in an integrated care setting, and that it should not be required for a patient to have a direct relationship with all of those groups that technically use and have access to the information.
The AHA also proposes that all treating providers should be given access to patients’ substance use disorder treatment records. Currently, patients must give official consent before treating providers can access those records, which is a barrier to integrated patient care. Further, in certain instances, not having access to that data can put a patients’ health at risk
The AHA proposes Overdose Prevention and Patient Safety Act (H.R. 3545) reforms should be passed and “fully align requirements for sharing patients’ substance use disorder treatment records with HIPAA regulations that allow the use and disclosure of patient information for treatment, payment and healthcare operations.”
This would guarantee that all providers and organizations that have a direct treatment relationship with an individual have access to that person’s complete medical history. including their history of treatment for substance use disorder.
The AHA also proposed Congress cancel Stage 3 Meaningful Use requirements, stating that the regulatory burden on hospitals and health systems is already large, yet those requirements have no clear benefit to patient treatment.