What major medical groups want in regulatory relief

The American College of Physicians (ACP), the American Hospital Association (AHA) and the Federation of American Hospitals (FAH) submitted comments to the House’s health subcommittee suggesting options for rolling back healthcare regulations on quality measures, hospital ratings and physician self-referral laws.

The groups shared several common ideas in suggestions to subcommittee chairman Rep. Pat Tiberi, R-Ohio. For example, both the AHA and FAH called for suspending CMS’ star ratings for hospitals, criticizing its methodology and calling them “misleading” to patients trying to compare facilities based on quality.

“We urge Congress to require CMS to suspend the faulty star ratings from the Hospital Compare website immediately,” the AHA wrote.

All three groups encouraged streamlining the number of quality measures required of clinicians and hospitals. FAH said Congress could rein in executive branch agencies by requiring all quality measures to be tested and reported publicly before being included in any CMS payment program. AHA even asked for Congress’s help in getting recent regulatory decisions reversed, suggesting lawmakers require CMS to suspend changes made to post-acute care reporting which were finalized after Aug. 1, 2015.

ACP asked for several quality reporting changes, including “simplifying” scoring in the Merit-based Incentive Payment System (MIPS) and getting more input from industry groups to ensure new measures are clinically relevant.

“It is important to constantly monitor the evolving quality measurement system to identify and mitigate any potential unintended consequences, such as increasing administrative burden and clinician burn-out, adversely impacting underserved populations and the clinicians that care for them, and diverting attention disproportionately toward the things being measured to the neglect of other critically important areas that cannot be directly measured (e.g., empathy, humanity),” ACP wrote.

Many of their suggestions revolved around asking Congress to restrict CMS’s authority. In one example, both the FAH and AHA wanted some congressional on the agency’s “intrusion” into standards used by private accreditation organizations (AOs) like the Joint Commission. The current administration has already signaled a willingness to inject itself into regulations around AOs, proposed their survey reports of hospitals be made public for the first time—an idea later left out of the finalized inpatient payment rule for 2018.

The hospital groups only differences in priorities seem to be a matter of wanting different degrees of change, like the AHA wanting Stage 3 of Meaningful Use canceled, while the FAH only called for it to be re-evaluated and limited to a 90-day reporting period in its first year.

A sizeable portion of both the FAH and AHA’s comments dealt with creating exceptions under the physician self-referral law, known as the Stark Law, and the Anti-Kickback Statute. While the FAH did say the law shouldn’t be changed to allow for greater self-referral to physician-owned hospitals—which the group said would lead to cherry-picking patients to avoid Medicare beneficiaries—it appeared to echo AHA’s arguments in allowing greater exceptions under those laws for clinical integration arrangements.

“Hospitals and other providers are now more accountable than ever for financial and patient outcomes across the entire spectrum of care,” the AHA wrote. “This collective accountability requires hospitals, physicians and other providers to work together in new ways. They must be able to financially align themselves with shared incentives, shared resources, seamless technology and pooled information. However, current laws impede innovation.”