Image by Jacqui from PixabayIn a sweeping move that could reshape health care administration across the country, the U.S. Department of Health and Human Services (HHS) has unveiled a major restructuring plan.
Under the plan, HHS will reduce its workforce from 82,000 to 62,000 employees and consolidate 28 divisions into 15, with the aim of streamlining administrative functions and centralizing processes such as human resources, information technology, procurement, external affairs and policy, according to a Trump administration announcement.
HHS Secretary Robert F. Kennedy, Jr., introduced this overhaul, described as a move to “Make America Healthy Again” by “driving efficiency” within one of the largest federal agencies.
For ambulatory surgery center (ASC) operators, the most immediate impacts are likely to emerge from the changes affecting the Centers for Medicare & Medicaid Services (CMS). The agency will cut approximately 300 positions, although HHS has said that Medicare and Medicaid coverage for beneficiaries will remain intact.
These cuts will not weaken essential services and the realignment primarily targets duplicative tasks, officials said. Nonetheless, ASC operators should remain vigilant for any shifts in compliance oversight or administrative procedures.
“It’s possible that the reduced manpower will result in delays in processing reimbursement of claims,” Ron Grace, principal at Polsenelli, told Ambulatory Surgery Center News. “While CMS is obligated to pay claims in a timely manner under contract, it will be interesting to see how this plays out – and, when there are delays, whether there will be an accommodation to the ASCs in the form of an interest payment or otherwise.”
Another significant element of the reorganization is the appointment of a new Assistant Secretary for Enforcement, who will oversee the Departmental Appeals Board, Office of Medicare Hearings and Appeals, and Office for Civil Rights.
HHS said that consolidating these responsibilities is designed to combat waste, fraud and abuse in federal health programs.
Grace said that he doesn’t anticipate any diminishment of enforcement as a result of the staffing cuts given the increased governmental scrutiny over the past years.
“With the newly created Assistant Secretary for Enforcement position, there could actually be an increase in government scrutiny and enforcement with respect to compliance with Medicare regulations, fraud and abuse and reimbursement claims,” he said.
While he doesn’t anticipate delays in obtaining Medicare certification for ASCs given that many ASCs obtain certification through other processes such as accrediting agencies, Grace said that he does anticipate that the reduced manpower will likely result in reduced “surprise” surveys.
In addition, the creation of the Administration for a Healthy America (AHA) merges multiple agencies, including the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Toxic Substances and Disease Registry, and National Institute for Occupational Safety and Health (NIOSH) into a unified body.
The reorganization also involves shifting the Administration for Strategic Preparedness and Response to the Centers for Disease Control and Prevention, and reducing staff counts at the Food and Drug Administration, the National Institutes of Health (NIH) and CMS in ways that HHS insists will not interfere with fundamental activities.
NIH, for example, will centralize procurement, communications and human resources to avoid “redundant” structures across its various institutes, according to the Trump administration.
Although the immediate effects of the restructuring on ASCs may be limited, the long-term implications could be more significant if HHS’s intensified focus on chronic disease prevention leads to a transformation in how outpatient services are utilized.
“Over time, bureaucracies like HHS become wasteful and inefficient even when most of their staff are dedicated and competent civil servants,” Secretary Kennedy said.
