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U.S. Departments of Health and Human Services, Treasury, Labor Release Health Care Competition Report

December 04, 2018

In fulfillment of an October, 2017, presidential Executive Order, the U.S. Departments of Health and Human Services, Treasury, and Labor today released a report intended to make recommendations that would facilitate a high-quality, affordable health care system by promoting choice and competition.

The report identifies four areas wherein it deems state and federal rules inhibit adequate choice and competition, and offers policy recommendations related to each:

  • Health care workforce and labor markets
  • Health care provider markets
  • Health care insurance markets
  • Consumer-driven health care

Among the recommendations, the report suggests that Congress consider broadening the scope of practice of advanced practice clinical professionals; increasing access to telehealth; and developing non-burdensome, flexible value-based care models—three initiatives HAP has advocated for during the past few years.

While many of the report’s recommendations support the current administration’s ongoing initiatives—including the Centers for Medicare & Medicaid Services Patients over Paperwork initiative—the report also recommends policies that could significantly impact the health care landscape in Pennsylvania:

  • Repealing the Affordable Care Act’s limit on physician-owned hospitals
  • Scaling back of federal mandates on health care coverage

The report also recommends establishing site-neutral payment policies, which provide payment based on the acuity of the patient, rather than the site of service. HAP and the hospital community have urged federal policymakers to ensure that the payment rates reflect an appreciation for the cost of supporting hospital-level care in community settings, arguing that the fundamental underpinnings of site-neutral payment policies are erroneous. Specifically, HAP has asked policymakers to consider that:

  • Hospitals treat sicker, medically complex patients, for whom the hospital is the appropriate setting
  • Hospitals have 24/7 emergency stand-by capacities that provide safety nets for vulnerable patients, and provide specialized services such as trauma, psychiatric, obstetrics, and pediatric emergency care
  • Hospitals play a crucial role in our emergency preparedness structure. They are prepared to respond to natural disasters, public health crises, and mass casualty events
  • Hospitals have more comprehensive licensing, accreditation, and regulatory requirements

Given the interest by both the Trump Administration and Congress, site-neutral payments will continue to be a prominent policy conversation in Washington, D.C.

HAP will continue to monitor developments related to the report’s recommendations. 

Please contact Laura Stevens Kent, vice president, federal advocacy, or Kate Slatt, senior director, health care finance policy, with questions regarding advocacy efforts or specifics of the proposed payment policy.

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