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Patients Before Paperwork: Reducing Administrative Burdens
In 2015, ACP launched its Patients Before Paperwork Initiative. This initiative is designed to reinvigorate the patient-physician relationship by challenging unnecessary practice burdens. The 2017 position paper, Putting Patients First by Reducing Administrative Tasks in Healthcare, 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 continues to identify and prioritize the most burdensome administrative tasks faced by ACP members and their patients, to develop significant policy recommendations for how to address these administrative tasks, to engage in ongoing outreach and stakeholder engagement efforts with external sources of administrative and regulatory burden, and to offer education and solutions to mitigate some of these burdens.
Prior authorization is the number one cause of burdens to physicians and other providers when it comes to delivering patient care. These resources are intended to provide some tips and solutions to help practices mitigate the burdens of prior authorization.
ACP - Medicine Forward Webinars
- Breaking Bad! Prior Auth Harms the Physician-Patient Relationship – This recorded panel, in collaboration between ACP and Medicine Forward, addresses problems and workflow solutions to address the burdens of prior authorization. (1 hr. 28 min)
- Register Now: Breaking Bad Part II: ACP and Medicine Forward Advance Solutions for Prior Authorization October 3, 2022, 6:00-7:30 pm ET
Drugs, Devices, and DME
Insurance companies require prior authorization for some drugs and devices to ensure appropriateness.
- Electronic Prior Authorization videos – These 3 short videos from AMA address the advantages of using electronic prior authorization.
- Prior Authorization Tips - This tip sheet from AMA offers practical solutions and the pros and cons of each.
- Electronic Prior Authorization (ePA) - This 10-minute video series from the AMA outlines the burdens of the current manual PA processes, describes how pharmacy ePA can help improve PA processing times, and explains how physicians can implement ePA in practice.
Imaging, Labs, Testing
- How to Avoid Peer-to-Peer Calls - When ordering imaging, prior authorizations go through radiology benefit companies, who are contracted by insurance companies. This video provides four key strategies to limit the number of calls required to obtain approval. (44 min)
- Laboratory & Imaging Test Ordering, Tracking, Results Review, and Reporting Results to Patients - This policy and procedures document was created to ensure timely and appropriate review of all laboratory and imaging results/tests ordered by the practice.
What ACP is Doing
- ACP Letter of Support for H.R. 8487, The Improving Seniors Timely Access to Care Act (08/03/2022)
- PA-ACP Thanks Senate for Passage of Prior Authorization and Step Therapy Reform Bill (06/29/2022)
- ACP Offers Suggestions for Implementation of Electronic Prior Authorization Systems (04/15/2022)
- ACP Letter of Support for H.R. 3173, The Improving Seniors Timely Access to Care Act of 2021 (02/25/2022)
- ACP Support Changes to CMS Prior Authorization Rule, but Concerned Not All Aspects Addressed (01/22/2021)
- Mitigating the Negative Impact of Step Therapy Policies and Nonmedical Switching of Prescription Drugs on Patient Safety: A Position Paper of the American College of Physicians (2020)
- Internists Warn Against the Negative Impact of Step Therapy Policies and Nonmedical Switching of Prescription Drugs on Patient Safety (11/30/2020)
- ACP Joins Others in Advising CMS on Best Ways to Reduce Prior Authorization Burdens (10/18/2019)
Electronic Health Records
Electronics Health Records (EHRs) were created to streamline practice workflows and improve patient care, but at the same time they also add burden. 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.
- State of the Note Summit 2021 - ACP worked with the EHR Association (EHRA) 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’ 2021 E/M code changes and accompanying documentation requirements but are generally applicable to clinical documentation.
- Primary Care Do’s and Don’t’s - This one-pager provides simple tips on how to streamline clinical documentation.
- Medical Specialty Do’s and Don’t’s - This one-pager is designed for the specialist.
- Five Recommendations for EHRs
- Automatically write in SOAP, and review in APSO
- Combine Patient Instructions and A&P
- Automatically expand abbreviations for patient-facing documents
- Allow linking out to data that is elsewhere in the EMR
- Allow for simple inclusion of discrete exam data
- Health IT and Health Information Exchange Basics: 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 Blocking Key Terms and Acronyms - Key terms, definitions, and acronyms associated with regulations.
- Interoperability and Information Blocking Regulations - Resources regarding the ONC and CMS final regulations aimed at improving interoperability and patient access to EHRs.
- FAQ on Information Blocking: To Block or Not Block - Describes the various expectations to claim and document if deciding not to share information.
- FAQ on Information Blocking: EHR and Health IT System Guidelines - Describes EHR functionalist needed and highlights questions to ask your vendor.
- FAQ on Information Blocking: Patient Access - Describes how to address questions and concerns around patients’ increased access to health information.
- Use of Health Information Technology to Advance Patient Care - This policy and procedures document explains the importance of practice staff understanding the appropriate use of technology.
Patient Portal Communication
- Patient Portal Playbook – This chapter of the ONC’s Patient Engagement Playbook offers tips on optimizing use of the patient portal using staff, APIs, and other technology.
- Sample Patient Portal Agreement – This sample document can be used as a 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 - This policy and procedures document focuses on the importance of communication with patients to create a patient-centered practice and good clinical care.
What ACP is Doing
- Health Information Privacy, Protection, and Use in the Expanding Digital Health Ecosystem (07/2021)
- Ethical Guidance for Electronic Patient-Physician Communication: Aligning Expectations (06/2020)
- Draft Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs (01/28/2019)
- Ethical Implications of the Electronic Health Record: In the Service to the Patient (03/20/2017)
- Clinical Documentation in the 21st Century (02/15/2015)
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.
- Annual Prescription Renewal – This module helps save time as well as improve patient adherence.
- Needy Meds – For patients for whom cost of drugs is a problem, staff can use this website contains information on prescriptions assistance programs, free and low-cost clinics, government programs, and other assistance programs.
- Prescribe Generic Drugs
- Information for Consumers and Patients - Information for consumers on drug-related topics including side effects, medication use, and medication fraud, etc., from the U.S. Food & Drug Administration (FDA).
- Medication Check-List
- Medication Adherence Inventory
- Medication Management & Electronic Prescribing
- Improving Medication Adherence (Video) - Dr. Marie Brown and receptionist Ms. Rockett describe one way to improve medication adherence.
- Substance Use Patient History
What ACP is Doing
- Policy Recommendations for Public Health Plans to Stem the Escalating Costs of Prescription Drugs: A Position Paper from the American College of Physicians (12/03/2019)
- Policy Recommendations for Pharmacy Benefit Managers to Stem the Escalating Costs of Prescription Drugs: A Position Paper from the American College of Physicians (12/03/2019)
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 email@example.com or discuss these issues in the Member Forum on Promoting Physician Well-being and Professional Satisfaction (ACP Membership 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.