The American Hospital Association (AHA) has urged President Donald Trump to avoid “abrupt changes” to the Affordable Care Act that could destabilize the health care sector.

The plea from AHA President and CEO Rick Pollack came near the end of a four-page wish list the hospital lobby sent to the president, who has vowed to repeal Obamacare.

Mr. Pollack’s letter highlighted five areas of concern for hospitals: reducing the regulatory burden; enhancing affordability and value; continuing to promote quality and patient safety; ensuring access to care and coverage; and continuing to advance health care system transformation and innovation.

“The regulatory burden faced by hospitals is substantial and unsustainable,” Mr. Pollack wrote. “Reducing the administrative complexity of health care would save billions of dollars annually and would allow providers to spend more time on patients, not paperwork.”

The AHA wants the Trump administration to:

• Cancel Stage 3 of the meaningful use program.
• Incorporate a financial penalty for high rates of incorrect denials that lead to unnecessary appeals in the auditor contractor contracts.
• Create safe harbors and waivers under the antikickback statute.
• Revise the Stark law on physician self-referral.
• Standardize the federal merger review process between the Federal Trade Commission and the Department of Justice.
• Eliminate outdated regulations that threaten access to postacute care.
• Adopt comprehensive solutions to address escalating drug prices.
• Protect the 340B drug-pricing program.
• Continue to challenge major health insurance company mergers and other anticompetitive conduct.
• Explore policies to help rein in medical liability.
• Explore Medicare structural reforms to make the program more sustainable while maintaining access to care, ensuring adequate payment for care, and protecting individuals from excessive financial burden.

To promote quality and patient safety, the Trump administration was asked to:

• Streamline, prioritize, and simplify quality reporting.
• Modify the current readmissions policy to include a sociodemographic adjustment.
• Suspend the flawed and misleading hospital star ratings on the Hospital Compare website.
• Develop a performance reporting option that allows hospital-aligned physicians to fulfill the Medicare Access and CHIP Reauthorization Act quality reporting requirements based on hospital measures.
• Stop federal agency intrusion in private-sector accrediting body standards and survey processes.
• Advance health information technology by supporting the adoption of interoperable electronic health records and promote more consistent use of information technology standards.
• Reject reductions in Medicare funding for graduate medical education.
• Continue funding for the Children’s Health Insurance Program.
• Improve access to mental health services.
• Remove barriers to mental health treatment.
• Provide funding to implement the Comprehensive Addiction and Recovery Act.
• Reject “site-neutral” payment cuts that prevent hospitals from modernizing their facilities.
• Urge Congress to remove impediments preventing veterans from using the Veterans Choice Program.

To advance health system transformation and innovation, the new administration was asked to:

• Preserve and improve upon new payment and delivery models
• Promote the use of telehealth and remote patient monitoring
• Waive the skilled nursing facility three-day stay rule, telehealth restrictions, and prospective beneficiary assignment from all accountable care organization models
• Expand the definition of advanced alternative payment models
• Provide new options on care delivery that reward better, more efficient, coordinated care and help ensure access to essential health care services