There are three mistakes to avoid in healthcare government relations. As a Minneapolis healthcare government relations firm, we help our clients avoid these mistakes and achieve competitive advantages from understanding evolving government regulatory and statutory changes. The three mistakes to avoid in healthcare government relations are:

1. Ignore ongoing regulatory and legislative changes that might impact your business. If you’re in healthcare, government regulation is likely to impact you from any number of directions; including the FDA, Meaningful Use, HIPAA, ICD-10 (by the way, ICD-11 is being developed), Medicare rules and reimbursements, you name it. And that’s just at the Federal level. State regulations need to be watched, too, as well as the occasional oddball bill introduced at a state legislature.

A regular monitoring program that follows regulatory areas of importance to you will provide an early alert if a problem is developing and hopefully give you time to adapt or even to help stop or at least modify a pending regulation. Often, pending regulatory changes are signaled years in advance (though not always) by earlier draft regulations, Congressional hearings, think tank reports and by other means. Consistent monitoring will prevent surprises and may provide opportunities. Once the regulatory train has left the station, the chances of stopping it go down dramatically.

Chances are, there are people in government thinking about your business right now.

2. Avoid formulating a long-term strategy that identifies risks and opportunities and sets goals. The value of a comprehensive audit of pending or potential regulation is you can prioritize the most significant issues and assess not only where your interests are threatened, but where there might be an opportunity. For example, what if an agency of the Federal government is proposing a requirement that plays to a core expertise or sweet spot of yours?

In addition, effective healthcare PR and marketing communications target real pains and real needs of customers. As a Minneapolis healthcare PR agency, we look to pending government regulations as guideposts to what key buyers and decision makers will be concerned with 6-12 months or more from now. With that kind of lead time, we can make our clients the thought leaders of  issues the market will be worrying about 6-12 months later.

3.Do not allocate any internal or external resources to government relations. Monitoring and creating strategy does no good if you don’t have somebody following the government for you. Many trade associations will offer monitoring and advocacy on your behalf. If you’re not a member of a trade organization that offers these services, consider joining one. But even the best trade organizations may not keep track of issues that are central to your future, and associations do not generally advocate directly for your company; they address issues common to all their members. You may well need a customized approach with resources you control. Dedicating time by an employee for government relations can make sense if you have someone on board with the knowledge, skills and interest. Another alternative is to hire an outside firm with a track record of following healthcare issues and getting good results for their client. However you do it, buy in and participation by senior management will be key.

The digitization of the American health care system began earlier this year with the launch of the Health Information Technology and Economic Health (HITECH) incentive program. Eligible providers and hospitals who install certified electronic health record (EHR) systems and use them in a meaningful way will receive incentive payments from the federal government to help defray the cost of the installation. The program could cost as much as $30 billion over the next decade, fulfilling President Obama’s goal of having an electronic health record for every American by 2014.

As is typically the case with government programs of this scope and magnitude, HITECH is being implemented in stages.  Stage 1 was launched this past January. Stage 2 is set to follow in 2013 and Stage 3 two years later.  The HIT Policy Committee, a public private advisory council created by HITECH and tasked with the defining “meaningful use”, already has draft criteria for Stage 2 which were subjected to public comment in February. Though stakeholders generally supported the proposed criteria, many eligible providers, hospitals and HIT vendors complained that the January 2013 launch date for Stage 2 was much too aggressive.

Several options for delaying Stage 2 are currently being considered by the HIT Policy Committee’s Meaningful Use work group. The first would involve carrying over the 90-day reporting period from Stage 1 into Stage 2. Since doctors and hospitals would only have to be compliant on Stage 2 criteria for 90 days during 2013, they could effectively delay implementation 9 months until October 1^st. The second option would simply push the start date for Stage 2 to January 2014.  A third alternative is to split Stage 2 criteria into two groups: those that draw upon Stage 1 HIT functionality would launch on schedule; those that require new HIT functionality would be delayed until 2014.

Don’t expect the Centers for Medicare and Medicaid Services (CMS) to immediately embrace delay. An overly aggressive deadline is a common complaint heard by regulatory agencies. The critique on Stage 2 timing was loud but not universal, with consumer advocates strongly in favor of maintaining the current timelines. Even some doctors and hospitals support the 2013 launch. This past Friday in a hearing held by the Meaningful Use work group, representatives of a small physicians group in Wisconsin and a federally qualified health center in Washington DC both voiced support for the current HITECH timeline.

While maximizing HITECH payments represents a strong incentive for doctors and hospitals to implement Stage 2 on time, there is no penalty for failing to do so. Penalties in the form of reduced payments from Medicare do not begin until 2015. In lieu of delay, CMS may decide to scale back new Stage 2 criteria, particularly those that require new HIT functionality. And from a purely political standpoint, delaying a program is usually a signal that that program is not working. Neither President Obama nor HHS Secretary Sebelius want to send that message about HITECH, particularly during an election year.

Look for CMS to adhere to the current January 2013 launch for Stage 2 in the Notice of Proposed Rulemaking tentatively scheduled for release later this year. CMS loses nothing in proposing the current timeline in the NPRM and gauging stakeholder support or opposition for delay. By that time, more data will also be available on Stage 1 participation. Short of universal hue and cry in support of delay, and data showing unusually low participation in HITECH, the January 2013 launch of Stage 2 will most likely remain in place.