Medicare and PPACA
In terms of time, energy, and financial resources, Medicare and the Patient Protection and Affordable Care Act are the regulatory programs that healthcare leaders love to hate, according to survey respondents.
Medicare edges out the PPACA as the biggest regulatory headache (19% to 17%) and the one that will require the highest long-term investment in human capital (19% to 16%).
The survey results speak to the complexity of Medicare rules and regulations, as well as the significant role the Medicare business plays at hospitals and health systems.
At Singing River, because between 45% and 55% of the patients are Medicare beneficiaries, Taylor says hospital officials are ever mindful that there are "civil and monetary penalties of consequence" for not meeting the program's contractual requirements or improperly applying Medicare policies.
Plus, adds Taylor, it's tough to have a significant portion of your budget "that is out of your control" in the sense that "you can't negotiate with the government payer and you can't impact the reimbursement structure."