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Patients Before Paperwork: Reducing Administrative Burdens

’s Patients Before Paperwork Initiative is designed to reinvigorate the patient-physician relationship by challenging unnecessary practice burdens. , makes “recommendations to address the issue of administrative tasks to mitigate or eliminate their adverse effects on physicians, their patients, and the healthcare system as a whole.”

ACP strongly advocates to alleviate the most burdensome administrative tasks faced by ACP members and their patients. We identify which tasks present the most burden, develop recommendations about how to address these administrative tasks, engage in outreach and stakeholder engagement efforts with external sources of administrative and regulatory burden, and offer education and solutions to mitigate these burdens.

Prior Authorization

Prior authorization is the number one cause of burdens to physicians and other health care professionals when it comes to care delivery. These resources provide tips and solutions to help practices mitigate the burdens of prior authorization.

ACP Toolkit (published October 2023) addresses Prior Authorization reform and provides a comprehensive overview of the policy landscape and ways individuals can help advocate for reform at the state and federal levels.

What ACP is Doing

 

ACP and Medicine Forward

Webinars

Drugs, Devices, and DME

Insurance companies require prior authorization for some drugs and devices to ensure appropriateness.

  • – These 3 short videos from AMA address the advantages of using electronic prior authorization.
  • – This tip sheet from AMA offers practical solutions and the pros and cons of each.
  • – This 10-minute video series from the AMA outlines the burdens of the current manual PA processes, describes how pharmacy ePA can help improve prior authorization processing times, and explains how physicians can implement ePA in practice.

Imaging, Labs, Testing

Electronic Health Records

Electronic health records (EHRs) were created to streamline practice workflows and improve patient care, but often they also create burdens for health care practitioners. These resources are intended to provide tips and solutions on documentation, information sharing, and communicating using the patient portal to help practices mitigate some of these burdens.

Documentation

  • State of the Note Summit 2021 – ACP worked with the EHR Association to develop tools to streamline clinical documentation, while avoiding “note bloat” and other burdensome documentation practices. These resources were intended to help physicians adapt to CMS’s 2021 E/M code changes and accompanying documentation requirements but are generally applicable to clinical documentation.
    • Primary Care Do’s and Don’t’s – Tips on how to streamline clinical documentation for general internal medicine physicians.
    • Medical Specialty Do’s and Don’t’s – Tips on how to streamline clinical documentation for specialists.
    • Five Recommendations for EHRs:
      1. Automatically write in SOAP, and review in APSO
      2. Combine Patient Instructions and Assessment and Plan
      3. Automatically expand abbreviations for patient-facing documents
      4. Allow linking out to data that is elsewhere in the EHR
      5. Allow for simple inclusion of discrete exam data
  • – Resources defining key aspects of health IT and summarizing the potential benefits of integrating technology into practices to improve patient outcomes, including through health information exchange, which allows clinicians and patients to securely access and share a patient’s medical information electronically.

Information Sharing

Patient Portal Communication

  • – Chapter of the ONC’s Patient Engagement Playbook that offers tips on optimizing use of the patient portal using staff, application programing interfaces, and other technology.
  • Sample Patient Portal Agreement – Model for developing an agreement with your practice’s patients.
  • Virtual Check-in or Online Digital E/M codes – Virtual check-in codes can be used for brief conversations where a clinician seeks to determine whether an in-person visit is necessary. Online digital E/M codes can be used for patient-initiated interactions via the patient portal.
  • Team Care: Communicating with Patients – Sample policies and procedures for communication with patients; to be used as-is or edited to meet the needs of your practice.

What ACP is Doing

Prescribing Medications

Managing multiple medications and counseling patients regarding use, cost, and side effects can be time consuming. These resources provide tools to help clinicians, staff, and patients manage their medications.

  • – Module that saves time and improves patient adherence.
  • – Information about prescription assistance programs, free and low-cost clinics, government programs, and other assistance programs.
  • – Information for consumers on drug-related topics including side effects, medication use, and medication fraud, etc., from the U.S. Food & Drug Administration.
  • Medication Checklist
  • Medication Adherence Inventory
  • Medication Management & Electronic Prescribing
  • (Video) – Dr. Marie Brown and receptionist Ms. Rockett describe one way to improve medication adherence.
  • (ACP Internist Article and Video) – Martha Gray, MD, FACP, talks about increasing medication adherence.
  • Substance Use Patient History
  • - Information about Section 1262 of the Consolidated Appropriations Act of 2023 on the removal of the federal requirement for practitioners to submit a Notice of Intent to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD), from the Substance Abuse and Mental Health Services Administration (SAMHSA)
    • Drug Enforcement Administration (DEA)-registered prescribers must complete a one-time eight-hour on the treatment and management of patients with opioid or other substance use disorders starting on June 27, 2023.

What ACP is Doing

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Private Payers

Private insurance companies and their differing policies, procedures, and payments add complexity to medical practice today. Visit our Private Payer page to learn more about what each individual payer is doing regarding behavioral and mental health, telehealth, prior authorization, value-based programs, Medicare Advantage, and more.

What ACP is Doing

Quality Reporting

The Quality Payment Program (QPP) aims to reduce burden and improve health outcomes for Medicare patients while rewarding high-value, high-quality Medicare clinicians. The QPP offers clinicians two tracks based on their practice size, specialty, location, or patient population. The Merit-based Incentive Payment System (MIPS) builds on traditional fee-for-service payments by adjusting them up or down based on performance. Alternative Payment Models (APMs) financially reward clinicians for delivering high-quality, cost-effective care. Learn more about quality reporting by visiting our QPP page.

What You Can Do to Help

This brief survey is a means to communicate administrative pain points with ACP staff, share best practices, and help inform additional tools and services.

  • Tell us about your ideas to address administrative tasks.
  • Provide examples or vignettes explaining how these tasks have had an impact on your ability to care for a patient.
  • How can ACP best serve you to address these issues?

You may also contact us directly at policy-regs@acponline.org or discuss these issues in the Member Forum on Promoting Physician Well-being and Professional Satisfaction (ACP 鶹ֱapp required).


Search the ACP Policy Library

To access everything ACP has said related to Medicare reform issues search all policy statements, copies of testimony, and letters to government and non-government officials.