In yesterday's Wall Street Journal, there was an op-ed piece from Rich Umbdenstock, President of the American Hospital Association. Rich's message on behalf of hospitals from across the country is to the Federal Government. That message is that we don't need any more regulations, we need smarter regulations.
Currently, there are over 122,000 federal regulations which hospitals are responsible for each day. Many of these regulations are unnecessary, outdated, duplicative and counterproductive. What first and foremost comes to mind are the four separate federal programs that conduct redundant reviews of hospital payments to uncover improper billing. One is Recovery Audit Contracting (RAC), and it has become the most frustrating since the RAC auditor determines that care should have been handled differently and payment is now withheld even though everyone who delivered the care agrees that the care was appropriate. Hospitals are forced to appeal the decision and we have been right 75% of the time and winning our appeals. Now, there are so many appeals that the process has slowed to a crawl and our money is being withheld prospectively for a much greater period of time. These appeals cost hospitals a great deal of time, money and other resources and yet our concerns are ignored.
Hospitals strive to put patients first and make careful use of decreasing resources, but regulators make that more difficult each day. In order to successfully implement the triple aim of health care reform (better quality, healthier patients and lowering the cost of care), regulators must review all federal regulations to ensure that they allow hospitals to be successful going forward. Those 122,000 federal regulations equate to a process out of control when you add state regulations, Health Services Cost Review Commission regulations for Maryland hospitals, the IRS requirements, OSHA, MIOSH and the list goes on.