01 Nov, 2017

Are Regulations Hindering Patient Engagement?

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Any professional or patient in the healthcare industry understands that patient engagement is the most crucial factor surrounding this sector. When a patient is engaged with properly, it can be the deciding factor that indicates if the practice is successful, or if the industry is moving in the right direction.

As we continue to enter into the digital age, hospitals are integrating digital tools more than ever. These tools support the functions of patients’ medical records, medical portals, and even smartphone technologies. These devices have pushed value-based care between patients and doctors.

The problem, however, is when the digital tools don’t align with the federal regulations and requirements that hospitals have to follow. American Hospital Association has conducted a report that reveals that hospitals are dealing with this issue more than ever before.

“Every day, health systems, hospitals and post-acute care (PAC) providers – such as long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies – confront the daunting task of complying with a growing number of federal regulations.” The report suggests.

In order to fully expose the impact that regulations have on the healthcare industry, the AHA put together an extensive analysis that depicts the federal law and regulations found in nine regulatory territories.

These territories include:

  1.  Quality reporting
  2. New models of care/value-based payment models
  3. Meaningful use of electronic health records
  4. Hospital conditions of participation (CoPs)
  5. Program integrity
  6. Fraud and abuse
  7. Privacy and security
  8. Post-acute care
  9. Billing and coverage verification requirements

(Taken from AHA’s report.) 

The report directed interviews with 33 executives from four health systems. Among these systems, 190 hospitals were surveyed.

The Findings

The main findings of the report reveal that hospitals and health systems are spending an immense amount of money on administrative tasks, in order to comply with regulations.

“An average-sized community hospital (161 beds) spends nearly $7.6 million annually on administrative activities to support compliance with the reviewed federal regulations – that figure rises to $9 million for those hospitals with PAC beds.”

This number added up equals to be $38.6 billion dollars each year.

Speaking of regulations, hospitals must satisfy 629 regulatory requirements across nine domains, including PAC-related element. According to the report, the agencies that are in charge of these requirements include “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).”

Because of these regulations, hospitals are struggling with keeping up the requirements that are they need to function effectively. Learning how to keep up with regulations is a crucial goal for hospitals, and as of lately, its been a challenge and ultimately interferes with patient engagement. This is due to the fact that the pace of change does not align with new care delivery models, such as digital components.

“The frequency and pace with which regulations change often results in the duplication of efforts and substantial amounts of clinician time away from patient care.” AHA reports.

The requirements that are put on health systems also have an impact on quality reporting, because hospitals are devoting time and manpower and money, $709,000 annually, to accomplish the administrative aspects of reporting.

All in all, the report points out the struggles that healthcare systems are having when it comes to keeping up with regulations, as well as the extra burdens that are placed upon everyday tasks. AHA provides a framework of advice that can be used in order to limit these regulations.

“To reduce the burden and improve care coordination, the group recommends a number of actions, including suspending the hospital star ratings on CMS’ website, ending Stage 3 MU of EHRs and providing more regulatory flexibility in value-based payment models.” HealthcareDive reports. 

This report can help give consumers, and providers, a clear understanding about what is hindering the healthcare sector, in order to create new conversations that will drive productive change.

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