Survey Reveals 86 Percent of Practices Feel Regulatory Burdens Have Worsened

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ACP continues to advocate at the federal level to reduce regulatory burdens and free up physicians' time for patient care

Nov. 1, 2019 (ACP) – American physicians are under red-tape pressure, and it's growing, according to a new survey showing that a whopping 86 percent believe regulatory burdens have grown during the past year. The good news: The American College of Physicians is on the front lines of advocacy efforts in the nation's capital, guided by the principles of its landmark “Patients Before Paperwork” initiative.

The survey results were released in October in the Annual Regulatory Burden Report from the Medical Group Management Association. More than 400 medical practices were surveyed, and 86 percent of practices said regulatory burdens had grown during the past year; just one percent said burdens had decreased.

If they could spend less time and energy on regulatory burdens, 96 percent of practices said they could devote more resources to patient care. And 80 percent said they'd be able to focus more on new technology.

Prior authorization is very or extremely burdensome, according to 83 percent of practices, and 88 percent complained about the burdens of the federal government's Merit-based Incentive Payment System. According to the survey, 87 percent agreed that positive payment adjustments have not covered the costs of time and resources spent preparing for and reporting under the program.

Many of the practices surveyed are smaller and independent, said Shari Erickson, ACP's vice president of governmental affairs and medical practice, suggesting that they aren't yet benefitting enough from the federal government's attempts to reduce burden in areas such as clinical documentation and prior authorization.

“We're working very hard to address these burdens,” said Erickson. In fact, ACP advocacy is making a difference and improvements are in the works that we believe will allow physicians to see relief in the coming months.”

Following on from ACP's Patients Before Paperwork initiative, the Trump administration launched its own Patients Over Paperwork effort and has been working to reform clinical documentation and prior authorization. A new policy now allows physicians to review and verify documentation provided by other clinical team members, such as residents, nurses, and students without having to fully re-document it. And if the 2020 proposed physician fee schedule is finalized, 2021 will bring much-needed changes in documentation requirements for evaluation/management (E/M) codes, including eliminating the use of history and/or physical exam for purposes of determining the E/M code.

Additionally, ACP has provided extensive feedback to the Centers for Medicare and Medicaid Services regarding administrative burdens in response to the agency's recent request for information, a proposed rule regarding prior authorization for Medicare Part D, and prior authorization issues in Medicare Advantage plans.

However, Erickson noted that the Centers for Medicare and Medicaid Services only addresses federal health programs. “We need to work across the range of payers to ensure that these kinds of changes go into effect widely,” she said.

ACP is proud that its Patients Before Paperwork initiative has paid dividends by helping to guide policymakers. But ACP still needs to hear from individual members about the burdens they're facing so they can share these stories with government officials and others.

“Members can go to the survey section of our Patients Over Paperwork site and give us a snapshot of the burden they're facing,” Erickson said. “We've taken these stories and used them in our letters to CMS. They've really been helpful in bringing them a frontline perspective that it would otherwise be hard for them to gather.”

Moving forward, “we're hopeful that reforms will start to turn the tide for our members, slowly but surely,” Erickson said. “We will continue to make our case for change.”

More Information

Information on ACP's Patients Before Paperwork Initiative is available on the ACP website.

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