What HIM Professionals Can Expect from the Government Shutdown

EDITOR’S NOTE

Day 3 of the federal shutdown continues. This article by Rose Dunn is part of a special section today published by RACmonitor and ICD10monitor called The Lowdown on the Shutdown.

It’s an unsettling time for all of us. Unfortunately, our federal government has once again reached an impasse, unable to agree on a long-term budget solution for fiscal year (FY) 2026. Instead of stability, we face temporary stopgaps – sometimes for months, sometimes for just a single day. As a result, we now contend with the ripple effects, including thousands of “non-essential” government employees being sent home.

For health information management (HIM) professionals, the consequences are both direct and indirect. Here are some of the key impacts:

1. Expiration of Temporary Programs: With the shutdown, several temporary health programs have expired, such as the Acute Hospital Care at Home initiative and certain Medicare telehealth flexibilities. This forces some hospitals to discharge or transfer patients receiving at-home care. For HIM teams, that may mean more discharge records to process and transfer documentation to prepare.
2. Delayed Admissions: At the National Institutes of Health (NIH), new clinical trials cannot begin, and new patients cannot be admitted to its clinical center. HIM staff at NIH may experience a reduction in admissions to code, process, and support.
3. Regulatory and Service Delays: Updates from the Centers for Medicare & Medicaid Services (CMS) and other federal agencies are on hold. With reduced staffing at CMS, billing inquiries, appeals, and other support services are likely to face significant delays.
4. Limited Oversight: CMS may pause or scale back oversight activities such as healthcare facility surveys and certifications. While this might feel like temporary “relief,” these responsibilities will eventually resurface, often creating a backlog that hits organizations all at once.
5. Litigation Setbacks: Court cases requiring testimony from federal regulatory agencies are delayed, creating additional uncertainty for those waiting on outcomes.
6. Impact on Morale: Perhaps most concerning is the effect on people. Essential employees working without pay may be less responsive (or absent altogether) when handling applications for healthcare coverage or even Social Security. Contractors may also face disruptions in work and pay. For HIM colleagues employed in these environments, the uncertainty weighs heavily.
7. HIM Settings: For HIM professionals in private or non-governmental hospitals, workflows may remain largely unaffected. But for those employed by government entities, the situation varies:

• Essential staff are likely reporting to work to ensure that HIM functions continue while worrying about how long they can sustain without a paycheck.
• Non-essential staff may be sidelined, looking for temporary work to bridge income gaps.

Looking Ahead

This shutdown is a stark reminder that decisions made at the highest levels of government cascade down into the daily realities of healthcare and HIM. Regardless of setting, it is a challenging time for our colleagues across the field. We can only hope this shutdown is short-lived, and that when it ends, there is no lasting harm to our patients, our profession, or our dedicated workforce.