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Patients Before Paperwork

An ACP initiative to reinvigorate the patient-physician relationship by challenging unnecessary practice burdens.

ACP has long identified reducing administrative complexities or burdens as a priority. Actions taken to achieve this goal have included developing and maintaining related policy, participating in various efforts to work to alleviate specific regulatory and insurance requirements, and eliminating other unessential tasks that detract from patient care and contribute to physician "burn-out." However, we are now working to develop an evidence based, comprehensive approach to better address the top priority administrative complexities that are faced by ACP members.

ACP Strategies for This Initiative

  • Identify and prioritize which complexities are of the top concern for ACP members and their patients.
  • Educate ACP members, other physicians, consumer advocates, and policy makers on what makes up administrative complexities, including the intent of the requirement and how the complexity impacts patients and physicians.
  • Implement the most effective advocacy, stakeholder engagement, and practice support approaches to help mitigate or eliminate the top priority complexities and to help ACP members (and other physicians) address those complexities that cannot be eliminated.
  • Achieve results that reduce physician burn-out, help restore the joy of practice, and reinvigorate the patient-physician relationship.

Top Priorities for ACP Members

Identified via an ACP member and panel survey in 2013-14, and a focus group in 2014.
  • Electronic Health Record Usability
  • Quality Reporting
  • Dealing with Insurance Companies

What ACP Is Doing

Policy Development and Education

  • "Clinical Documentation in the 21st Century," Ann Intern Med. Online First February 17, 2015.
  • Paper under development to set a public agenda and outline broad policy recommendations for how to define and address administrative complexities.
  • Toolkit under development for use by ACP Chapters to facilitate the discussion of these issues and help identify solutions.

Feedback to Regulatory Agencies

  • Comments to the Centers for Medicare & Medicaid Services (CMS) regarding the Medicare Physician Fee Schedule.
  • Comments to the Office of the National Coordinator (ONC) regarding the Medicare EHR Incentive Program (i.e., Meaningful Use) proposed rules for Stage 3.
  • Testimony before the National Committee on Vital and Health Statistics (NCVHS) regarding prior authorizations.

Collaborations with Other Stakeholders

  • To ensure implementation of MACRA will not increase administrative burdens on clinicians.
  • To automate benefit eligibility criteria - led by NCPDP (a standards developer).
  • On the CMS Electronic Submission of Medical Documentation (esMD) project to automate requests for further information by payers on medical documentation.
  • To address potential increases in burden related to home visit documentation.
  • To ensure minimal burden related to the implementation of appropriate use criteria requirements.

Tools and Services Offered by ACP

Progress Reports

View or download PDF versions of our Progress Reports detailing how ACP plans to address administrative burdens relating to the priority areas of EHRs, Quality Reporting and Dealing with Insurance Companies.

What ACP Members Can Do to Help

Contact us at policy-regs@acponline.org or discuss these issues in the
Member Forum on Promoting Physician Wellness and Preventing Burnout.

  • Tell us about your best practices to address administrative burdens, especially in our top 3 identified priority areas: electronic health record usability, quality reporting, and dealing with insurance companies.
  • Send in specific examples or vignettes explaining how these burdens have had an impact on your ability to care for a patient.
  • And finally, how can ACP best serve you to address these issues?