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Analysis

CHIME Chimes in on Rising Healthcare Costs

By John Commins  
   March 06, 2019

Healthcare information managers urge Congress to address a burdensome and costly healthcare regulatory environment that is driving up costs and diverting resources away from optimal patient care.  

If Congress wants to stem rising healthcare costs, they could start by taking a look at expensive federal mandates.

That's one of several suggestions put forward by the College of Healthcare Information Management Executives in a six-page letter to Sen. Lamar Alexander, (R-TN) chairman of the Health, Education, Labor and Pensions Committee.

"Despite the infusion of nearly $40 billion for healthcare providers to adopt electronic health records, the costs to maintain those systems and ensure they are capable of enabling successful participation in federal programs comes with steep price tags," CHIME CEO Russell P. Branzell and CHIME Board Chair Shafiq Rab said in their joint letter.

"The 21st Century Cures Act recognized the need to bring transparency, especially around costs, to the EHR purchasing process, but there are many other financial burdens associated with participating in federal reporting programs," the letter said.

CHIME complained that while the Promoting Interoperability Program "altered the trajectory of EHR adoption… countless costs have continued to plague health systems to maintain compliance with the program mandates."

"The costs associated with new versions of certification, interface fees, quality reporting tools and patient engagement modules have forced health systems to choose between innovation or clinician requests and meeting federal mandates," CHIME said.

"Capital budgets are limited and as federal mandates amp up expectations, more and more resources continue to be dedicated to the Centers for Medicare and Medicaid Services or the Office of the National Coordinator's wishes, rather than those of the patient or clinician," the letter said, adding that "Congress must work with the administration to continue to infuse flexibility into the PI program, so it better aligns with patient and clinician needs."

CHIME highlighted other areas of concern, including:

  • Quality Measurement: "The burden of quality measurement that our members shoulder to meet reporting requirements levied by CMS is significant. Hours of work and expertise are required to comply with these reporting demands and such burdens are exacerbated by a lack of technical harmonization."
     
  • HIPAA Compliance: "The complexities with meeting HHS privacy and security requirements can be staggering. Audits by the Office for Civil Rights are perceived as being punitive and not assisting the organization to recover and learn from a breach. It is vital that Congress and HHS identify a pathway for ensuring providers do not unduly shoulder the burden of protecting PHI in situations outside their control."
     
  • Harmonizing Privacy and Consent Laws: "The exchange of data among providers in various locations and settings will require the harmonization of state and federal privacy laws. As an example, consent policy varies by jurisdiction and personal health information type, and similar to most privacy policy, there is no national consent policy."
     
  • Rethinking Telehealth policies: "Whether public and private payers cover telehealth services and adequately reimburse hospitals and other healthcare providers for providing those services, is a complex and evolving issue and, as a result, a possible barrier to standardizing the provision of these valuable services."

“Despite the infusion of nearly $40 billion for healthcare providers to adopt EHRs, the costs to maintain those systems and ensure they are capable of enabling successful participation in federal programs comes with steep price tags.”

John Commins is a senior editor at HealthLeaders.


KEY TAKEAWAYS

CHIME says audits by the Office for Civil Rights are punitive and dont' help organizations recover and learn from a breach.

Money that goes into meeting cumbersome federal guidelines is money diverted from patient care.

Shifting federal regulations around EHR, interoperability, privacy and consent laws, and data security leave hospitals and vendors in a constant state of flux.


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