2017 Federal Public Policy Agenda
The Oregon Association of Hospitals and Health Systems’ (OAHHS) and the Washington State Hospital Association’s (WSHA) joint federal public policy agenda addresses the federal policy challenges facing our members in 2017. This agenda aims to achieve five goals:
- Health care coverage for all residents of Oregon and Washington;
- Access to high quality health care services throughout our states;
- Fundamental delivery system reforms that reward quality of care and greater value for the dollars spent on medical care;
- Predictable and sustainable revenue streams that do not result in arbitrary cuts;
- An adequate supply of health care professionals;
- A common-sense approach to regulating health care providers that ensures accountability, but allows for flexibility to support a transforming health care system.
Preserving health insurance coverage is our top priority in 2017. Washington and Oregon were two states that expanded Medicaid through the Affordable Care Act (ACA). This expansion has led to hundreds of thousands of people having access to insurance. If changes must be made to the ACA, Congress should have a replacement option ready to implement before changing the law or funding streams.
OAHHS and WSHA are concerned about policies that would result in fewer people having access to health coverage. Specifically, we support:
- Preserving coverage for individuals, children and families. In particular, coverage that came through Medicaid expansion and the health insurance exchanges, but also through historic Medicaid eligibility;
- Funding levels from the federal government for Medicaid that maintains coverage, access to care, and does not harm our states’ operating budget. Funding levels should also reward our states’ efficiencies and lower utilization of health care services;
- Maintaining a stable commercial insurance market; and
- Ensuring seniors have access to affordable health coverage in both rural and urban areas.
Other Short-Term Initiatives:
- Preventing any further expansion of “site neutral policies.”
- Supporting reauthorization of the Children’s Health Insurance Program.
- Opposing efforts to restrict the 340B drug discount program, supporting legislation to include orphan drugs in the 340B program and monitoring efforts to control high costs for prescription drugs.
- Continued reform of federal behavioral health policies to increase the supply of professionals, improve critical information sharing between providers, and advocate for fixing CMS’s interpretation of the new Institutions of Mental Disease rule for stays greater than 15 days.
- Enacting policies that expand access to high quality medical treatment through telehealth and telemedicine capabilities.
- Opposing reductions to payments to critical access hospitals.
- Removing the 96-hour physician certification requirement as a Medicare condition of payment for critical access hospitals.
- Reversing rules that require “direct” – rather than “general” supervision for therapeutic services provided in outpatient departments of CAHs and small rural hospitals. Giving hospitals and eligible health care professionals more flexibility in meeting meaningful use requirements for electronic health records.
- Expanding rules allowing Medicare beneficiaries who are seen by mid-level practitioners to be attributed to rural accountable care organizations. Advocating legislative and other strategies to increase the number of residency training opportunities in Oregon and Washington, and working to correct errors in the residency caps.
- Permanently extending add-on payments for ambulance services in rural areas. Support the fully authorized funding amount for the Children’s Hospitals Graduate Medical Education Program for pediatric residency training.
OAHHS and WSHA members are committed to transforming the health care system into one that emphasizes coordination of care, quality of care, patient safety, and lower costs. In addition, we are committed to ensuring continued access to health care services in rural areas.
To be successful in this effort, hospitals and health systems must make significant long-term investments in new information technology, infrastructure, and changes to care delivery. Making these investments requires a predictable revenue stream for the future – something that has been difficult in today’s budget environment. Congress and federal agencies have imposed arbitrary and ad hoc reductions in hospital reimbursement to offset the cost of other programs. OAHHS and WSHA oppose such efforts.
As part of our effort to transform the delivery of health care, we will support:
- Developing and advocating for alternative payment methodologies that reward efficiency, quality improvement, patient safety, and care coordination, rather than volume of services.
- Ensuring public policies that enhance collaboration among providers and remove the legal barriers that now fragment the health care delivery system.
- Developing alternative reimbursement and delivery system models aimed at ensuring continued access to medical care in rural communities, recognizing the unique demographic, reimbursement, regulatory and work force challenges facing these areas.
- Fostering an approach to Graduate Medical Education that encourages primary care and rural care, and that creates a more fair allocation of GME slots across the country.
- Investments in innovative delivery system structures that will have long term payoffs, including flexibility and support for transformation projects to improve care delivery in our states.
Support state waiver initiatives that improve the quality of care delivered, provide better access to care, and lower the cost of delivering care for Medicaid patients.