Trump’s two-for-one regulation order: Its potential impact on healthcare

Trump With Hand Raised
President Donald Trump’s new executive order aimed to reduce the number of federal regulations could be good for the healthcare industry.

President Donald Trump’s new executive order aiming to reduce the number of federal regulations could be good for the healthcare industry, according to health policy experts interviewed by FierceHealthcare.

The order is designed to cut federal regulations by requiring departments and agencies to eliminate two existing regulations for every new rule they introduce.

For the rest of fiscal 2017, the cap requires that the cost of any additional regulations be offset by eliminating existing rules.

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“It should simplify compliance and reduce costs associated with data capture and reporting, but more detail is needed before anyone can know for sure,” health policy expert Paul Keckley, PH.D., told FierceHealthcare.

Relieve administrative burdens

Although implementation details are scarce, industry experts told FierceHealthcare that the rule shouldn't be too difficult to put in place in the heavily regulated healthcare industry.

“There are thousands of regulations pertaining to Medicare, Medicaid, and dozens of other programs. I doubt the Trump administration will want to do much new regulating, but if they do, it should be easy to find two obsolete or redundant regulations to eliminate for each new one,” said Alice M. Rivlin, senior fellow, economic studies, Center for Health Policy at The Brookings Institution, a nonprofit public policy organization based in the District of Columbia.

And, she speculated, if Congress and the new White House administration did something drastic, like turn Medicaid into a block grant, they could cut out thousands of regulations at once. “They ought to be able to bank those to use as offsets for some future new program, such as an expansion of Health Savings Accounts. All speculation at this point,” she said in an email to FierceHealthcare.

Rita Numerof, president of healthcare management consulting firm Numerof & Associates, said philosophically, the new order is a great idea.

“I think we have way too many rules, many of which are contradictory in this country. So creating less bureaucracy in principle, regardless of how you get there, is a good thing all around. I can’t see anybody objecting to that."

Order won't stop move to value-based care

And like Rivlin, she thinks it’s probably easier to implement than many people might think because there are so many healthcare regulations. She also doesn’t believe the executive order would slow healthcare’s move to value-based care.

"There’s been a lot of movement over the last several years to move to value and connecting payments to outcomes, which CMS quite frankly had never done before. And it set in motion the mechanism by which commercial payers could be focused on this conversation as well."

And, she notes, there is nothing to stop healthcare delivery organizations from using data to advertise in a commercial way the outcomes that they produce. “They don’t need to wait for Washington to tell them what to do,” Numerof said, adding, “I think Washington would’ve gotten a lot less involved in this if the private sector had done a better job of connecting payment to outcomes and really demonstrating value.”

Create more opportunities for patient-centered care

In a statement published on the American Hospital Association website, Rick Pollack said he believes the executive order is positive because it will help reduce red tape.

“Reducing the administrative complexity of healthcare would allow providers to spend more time on patients, not paperwork. In the past year alone, the federal government added 23,531 pages to the stack of existing regulations affecting hospitals and health systems,” said Pollack, who serves as president and CEO of the AHA.

The excessive red tape stands as a barrier to care and is a key driver of healthcare cost, Pollack said. He said the new order provides relief by reducing the administrative burden and open the door to make care even more patient-centric.

Impact to HealthIT

But not everyone is as optimistic. STAT notes that Trump’s regulatory order could create havoc at the Food and Drug Administration and lawmakers who aim to implement the bipartisan legislation, the 21st Century Cures Act.

Jeff Smith, vice president at the American Medical Informatics Association, told Politico that agencies need to look at policies required by law instead of regulations authorized by law. He pointed to last year’s EHR oversight rule as an example. That rule was never required by the 2009 HITECH ACT, he said, but could be a candidate for elimination.