New CMS COVID-19 Data Collecting Rule Will Devastate Hospitals

When Americans first learned about the coronavirus, one thing they knew they could count on was quality care from their local hospitals. Throughout this pandemic, caregivers on the frontlines and working in hospitals have risked their lives to heal and comfort patients and families in crisis. Another thing Americans thought they could count on – especially in the midst of this health crisis – was that their government would work with the healthcare system to bolster the response, not penalize it.

Shockingly, with little notice, the Centers for Medicare and Medicaid Services (CMS) is threatening, to cut Medicare reimbursements to hospitals via a newly proposed rule if they don’t immediately comply with new COVID-19 data reporting requirements. Gathering important data during a pandemic is important but creating chaos for hospitals during a catastrophe is a disaster Americans don’t need.

According to The New York Times, Medicare accounts for about 40 percent of hospital costs, compared to 33 percent for private insurers. That means the hospitals that are unable to comply with this rule would on average lose 40 percent of their funding; something that is simply unsustainable during a pandemic.

Given evolving reporting requirements and the need to respond with accurate data, hospitals are simply having a hard time keeping up with the red tape. Since the start of the pandemic there have been monthly, if not weekly changes, to the COVID-19 data tracking system.

In February 2020, the Department of Health and Human Services (HHS) said states were responsible for collecting and reporting their COVID-19 cases, so states set up their own data collection systems. In March, the White House decided they wanted their own data, so they asked hospitals to collect and send them data. On March 29, the White House stopped that system and sent letters to hospitals asking them to move to a federal data collecting system.

One week later, HHS Secretary Azar sent a letter to hospitals announcing five ways in which they could submit their data (only three ways existed at the time of the letter). This was quickly overturned, and HHS then said that there was only one way to send and collect data, through a private company called TeleTracking – the system that is currently used today – that was awarded a $10.2 million contract. Hospitals know that data collection is important but trying to treat patients and keep up with evolving reporting requirements in the midst of a pandemic is proving especially challenging.

The TeleTracking rollout has also been rocky. Public health experts are puzzled as to why HHS chose such a difficult time to employ an untested private vendor rather than improve the C.D.C.’s National Healthcare Safety Network (NHSN), a decades-old disease tracing system that is deeply familiar to hospitals. Up until the switch, hospitals were reporting about 70 elements into public health databases and now they are required to report a five-page list of 129 elements.

Hospitals were also only given days to send all this information to TeleTracking. HHS explained the sudden change by claiming it would streamline information gathering and help to allocate therapeutic pharmaceuticals like remdesivir. Long wait times for those calling for technical support with the TeleTracking system have also impeded the ability of hospitals to timely and efficiently report their data.

While the switch to TeleTracking appears to be part of a broader privatization effort, questions have also arisen as to why a small, privately owned company that has never collected data on this scale was awarded the contract and why the switch be made in the middle of a pandemic. CEO Michael Zamagias and his New York real estate ties have already been the topic of at least one investigative piece, and given Jared Kushner’s leadership of the coronavirus task force it is plausible that the questions will continue. While there is likely nothing to these allegations, it is yet another unnecessary distraction in the midst of this pandemic.

Trying to treat patients and keep up with evolving, burdensome and confusing reporting requirements in a pandemic is another challenge our hospitals shouldn’t be shouldering. After leading two large state HHS agencies, I can attest that this is not the kind of switch that should be made during a pandemic. While privatization makes sense at times, it doesn’t always work and with systems this large, gaining input from hospitals is key and detailed study must occur if it has any chance of success.

Government certainly needs to become smaller and more efficient, but not by sanctioning caregivers on the front line during an unprecedented pandemic. CMS should re-evaluate their COVID-19 data collection policies and find ways to work with hospitals, not over them.

Gary D. Alexander served as Rhode Island’s Health and Human Services Secretary from 2006-2011 and the Commonwealth of Pennsylvania’s Human Services Secretary from 2011-2013