Health Information Management

AHA offers comments on Congress healthcare reform bills

HIM-HIPAA Insider, January 12, 2010

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The American Hospital Association (AHA) offered comments and suggestions on the Senate and House healthcare reform bills in a January 7 letter to Congress.
The AHA commented on:
  • Hospital-acquired conditions (HAC): The AHA is critical of the Senate bill provision to add a 1% penalty to hospitals in the upper quartile of rates of HACs. “The combination of the current Senate provisions could put some hospitals at risk for three separate payment reductions for the same infections/HACs—once through the current policy, once through value-based purchasing, and once through the new 1% penalty for hospitals with the highest HAC rates. It is unfair for hospitals to be subjected to triple jeopardy if their performance falls short of their goals,” according to the AHA.
  • Readmissions: The AHA strongly disagrees with both the House and Senate bills, which impose financial penalties for “excess” (as opposed to “expected”) readmissions. The AHA believes that efforts to reduce readmissions should address “only avoidable and unplanned hospital readmissions related to the original admission.”
  • RACs: The AHA urges the removal of the Medicaid RAC provision currently included in the Senate bill, which extends RACs to Medicare Parts C and D, as well as the Medicaid program. The AHA says the addition is “unnecessary for maintaining or improving program integrity.”
  • Payment bundling: According to the letter, the AHA supports the testing of different models of bundling payments to improve coordination of care, noting that an appropriate evaluation is essential to determine what works and what does not before broad adoption. The AHA also offers support of the House bill language that supports “a wide array of models, including bundling payment for inpatient and physician services, inpatient and post-acute services, inpatient, physician, and post-acute services, and post-acute services only.”
AHA also comments on rural provisions, long-term care hospital concerns, offers support to health information exchange creation, and the Senate’s approach to a public plan option (i.e., creating state-based, non-public, nongovernmental healthcare co-operatives and non-public, multi-state health plans), and discusses a wide variety of other topics.
To read the letter, visit

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