The Centers for Medicare and Medicaid Services (CMS), the federal agency that administers much of the funding for elderly healthcare, has decided in the middle of a national pandemic to try to impose a new data reporting system for COVID-19 cases. At a time when our efforts should be focused on fighting the pandemic and making sure patients have access to care, this is an unnecessary distraction that will harm patient outcomes.
Why is this a problem? In a newly proposed rule, CMS is now threatening to withhold funding streams that account for over40 percent of hospital revenues on average (compared to 33 percent from private insurance) if they do not immediately adopt a new, more labor-intensive patient data tracking system called TeleTracking. As someone who earlier in my career administered 24 residential living, assisted living and nursing home facilities, I can attest to how important these revenues are to funding operations. Now is not the time, with the pandemic hovering over the healthcare system, to use an issue of administrative data collection to undermine hospitals.
Even under the best of circumstances, hospitals have a hard time breaking even, and under the peculiar and unique conditions of this pandemic, the lack of elective surgeries and other outpatient procedures has added further financial strain. Since 2005,170 hospitals in 36 states have closed their doors and that trend will likely continue if hospitals are deprived of their primary source of funding. Many of these smaller facilities would have the most difficulty adopting a new and totally different record keeping system, and the threat of sanctions as opposed to offering resources to help ease this transition would only made matters worse.
Even at larger facilities the increased staff time required to input additional data is a concern. TeleTracking requires nearly twice as many reporting elements as the previous system, further taxing already limited staff resources. As a practical consideration on how data is collected Becker’s Hospital Review reports that hospital staff including nurses, perform “over 100 tasks per shift while being interrupted every three minutes.” Piling new and challenging additional tasks is not the way to help hospital staff meet their goals of caring for patients.
How the contract was awarded has also been problematic since the start. Public records, which first showed the contract was a no-bid deal, have since been updated to correct a “coding error” and the Department of Health and Human Services now claims that the contract was in fact competitively bid. TeleTracking itself is a small, privately owned company which has never collected data like this, on this scale, and this has raised further questions as to their ability to meet the government’s needs.
Then there is the question of optics. For starters, it would be smart to avoid the perception that elderly patients could lose their hospital health care in the midst of a pandemic. Also, while the Trump Administration prides itself on reducing regulatory barriers and requirements, this CMS rule would take the opposite direction. And while the White House Coronavirus Task Force, headed by Jared Kushner, prefers dealing with private providers over government agencies, he would probably be wise to steer clear of an vendor with a short track record and a CEO that has links both to the New York real estate world and a firm that financed billions of dollars of projects with the Trump Organization.
Scrapping this proposed rule and putting any additional changes to reporting mechanisms on hold while TeleTracking is tested and perfected is the best course of action. Perhaps over time this system may be useful but trying to impose it in the midst of a pandemic and with the threat of withdrawing funding is wrong.
Hospitals already have decades of experience working with the existing C.D.C. National Healthcare Safety Network and have been expected to manage several other changes to the virus reporting structure since the start of this pandemic. There must be a way to deal with typical governmental issues of data collection and analysis without threatening a vital source of funding for our hospitals and the vulnerable populations they serve. Let’s use our common sense and withdraw this proposed CMS rule.
Earl Baker is the former Chairman of the Human Services Committee of the County Commissioners Association of Pennsylvania and previously served as CEO of a large healthcare organization in the Delaware Valley.