Reduce Unnecessary Paperwork Requirements

Reduce Unnecessary Paperwork Requirements

Cumbersome electronic health record (EHR) systems, utilization management policies, (e.g., prior authorization), and continuously changing regulatory rules are forcing physicians to spend more time on administrative tasks rather than spending time with patients. Even more time is spent on these burdensome tasks after hours. According to recent studies, physicians spend approximately half of their time working on EHRs and administrative work, in addition to completing paperwork after hours. In a 2023 study, 89 percent of practices surveyed responded that prior authorization requirements are, “very or extremely burdensome.”[i] Another study revealed that for every hour a physician spends on clinical time, nearly two hours are spent on EHR and administrative tasks every day.[ii]

Burdensome paperwork requirements are contributing to the physician shortage and are inhibiting appropriate patient care.[iii] Many physicians, burned out by paperwork requirements, retire early or leave medical practice for another profession, especially those in small, rural, and solo practices where they do not have the resources to manage all the paperwork requirements.[iv] As more of these practices are forced to close or relocate, healthcare shortages increase, and more communities lose access to care.

Although federal programs like the Medicare Quality Payment Program (QPP) and value-based care payment models are intended to improve health outcomes and reduce spending, these initiatives have significantly increased administrative burdens for physicians. The U.S. Centers for Medicare & Medicaid Services (CMS) has taken steps to reduce paperwork requirements through programs like the Patients Over Paperwork initiative and the creation of offices such as the Office of Burden Reduction and Health Informatics,[v] in addition to developing outcome measures that are clinically appropriate through the Meaningful Measures Framework. While ACOFP appreciates CMS’s commitment to allowing more time to be devoted to providing care, more action needs to be taken to achieve the goals of these programs and to reduce administrative burdens.

Through the U.S. Health Resources and Services Administration (HRSA), the U.S. Department of Health and Human Services (HHS) announced plans to distribute $103 million from the American Rescue Plan Act of 2021 (ARPA) over a three-year period to strengthen resiliency and address burnout in the health workforce. ACOFP supports funding efforts to address physician burnout and promote physician wellness to establish a culture of well-being among the physician community.

Advocacy Positions:

• Reduce burdensome paperwork requirements across federal programs to allow physicians to spend more time treating patients.
• Maintain and expand CMS’s efforts to reduce administrative burden, such as the Patients Over Paperwork initiative.
• Require EHR interoperability and standardize reporting requirements to reduce time spent on EHRs.
• Develop meaningful EHR reporting requirements to replace those that do not contribute to patient outcomes.
• Allow physicians to be reimbursed promptly for time spent preparing for patient visits and logging medical information into the electronic medical record beyond the day of the patient visit.
• Streamline utilization management policies across payers in a way that all stakeholders can quickly and efficiently address patient needs.
• Thoughtfully implement any major regulatory changes to Medicare to increase program certainty and to ensure that physicians have time to familiarize themselves with new program rules and update their practices accordingly.

[i] Medical Group Management Association. Annual Regulatory Burden Report. November 2023. Available at https://www.mgma.com/getkaiasset/423e0368-b834-467c-a6c3-53f4d759a490/2023%20MGMA%20Regulatory%20Burden%20Report%20FINAL.pdf

[ii] Sinsky C., Colligan L., Li L., et al. Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Ann Intern Med. 2016;165(11):753–760. doi:10.7326/M16-0961

[iii] Top challenges 2021: #1 administrative burdens and paperwork. Medical Economics. 2021;98(1):7–8. Accessed January 12, 2023. https://www.medicaleconomics.com/view/top-challenges-2021-1-administrative-burdens-and-paperwork