Prior authorizations and price transparency will be a main focus of advocacy for 2023.
Each year the American Hospital Association (AHA) releases an advocacy agenda focusing on key areas in need of “critical support” for hospitals and health systems, and this year, quite a few key areas will be focused on your revenue cycle.
“Hospitals and health systems are dealing with unprecedented challenges as they manage the aftershocks and aftermath of COVID-19. These include historic workforce shortages, soaring costs of providing care, broken supply chains, severe underpayment by Medicare and Medicaid, and an overwhelming regulatory burden, just to name a few,” the AHA said.
To address these challenges, this year’s agenda is broken down into four main areas of action:
- Ensuring access to care and providing financial relief
- Strengthening the healthcare workforce
- Advancing quality, equity, and transformation
- Enacting regulatory and administrative relief
Most of these key areas include specific agendas related to the revenue cycle.
The group says it wants to enact technological, legislative, and regulatory solutions to reduce administrative waste by streamlining prior authorization requirements and processes for hospitals so that clinicians can spend more time on patients rather than paperwork.
It also plans to support price transparency efforts by ensuring patients have access to the information they seek when preparing for care, including cost estimates when appropriate, and creating alignment of federal price transparency requirements to avoid patient confusion and overly burdensome duplication of efforts.
When it comes to surprise billing, the AHA says it plans to ensure that regulations to implement surprise medical billing protections for patients do not inadvertently restrict patient access to care.
Social determinates of health capture also made the agenda. The AHA says it will promote approaches to account for social risk factors in quality measurement programs where appropriate to ensure equitable performance comparisons and payment adjustments, and promote alignment and standardization of approaches to collecting, analyzing, and exchanging demographic and health-related social need data across federal agencies.
The AHA says it will work with Congress, the administration, regulatory agencies, courts, and others to positively influence the public policy environment for patients, communities, and the healthcare field.
There is much more than just revenue cycle-related challenges being addressed. The hospital association is also placing a focus on workplace violence, Medicare residency slots, the nursing shortage, and workforce diversity. Read more about those initatives here.
“Hospitals and health systems are dealing with unprecedented challenges as they manage the aftershocks and aftermath of COVID-19. These include historic workforce shortages, soaring costs of providing care, broken supply chains, severe underpayment by Medicare and Medicaid, and an overwhelming regulatory burden, just to name a few.”
Amanda Norris is the Revenue Cycle Editor for HealthLeaders.