ACOFP Blog
For Family, By Family—ACOFP Blog
ACOFP Federal Legislation and Advocacy Committee member Philip Eskew, DO, JD, MBA, highlights examples of the administrative burden of paperwork requirements and discusses actions taken to address this issue.
The current volume of required documentation is a daily contributor to mental fatigue and job dissatisfaction for many family physicians. Spending non-reimbursed, expected time navigating a patient’s complicated history is challenging enough. Osteopathic family physicians should not need the skills of a software engineer to navigate a third party driven electronic medical record (EMR) interface. Unfortunately, we are not the end user of the EMR (and neither is our patient). The end user is the third party payor, for whom it was designed.
Whether we are checking a box for a quality metric that should not apply to our patient or find ourselves attempting to explain to a third party payor lacking medical training why a particular intervention is necessary—stressors all add up. Direct primary care (DPC) physicians are fortunate in not having to spend as much time on these types of particular third party inefficiencies. Some administrative inefficiencies are still faced by all providers. Let’s focus on three examples and what you can do to reduce stressors.
It is prudent to not spend time arguing with administrative workers at these other offices. Educate your patient about their Health Insurance Portability and Accountability Act rights as modified by the Health Information Technology for Economic and Clinical Health Act. Outside a few narrow circumstances all patients have a right to demand and receive cash pay pricing (even when they have insurance).
Demand a peer-to-peer call and request that your patient be present during the call, informing them that the patient is present. Explain things once via phone and then with a follow-up letter (copying to the patient) that explains why the intervention is necessary. If the request is denied there is no need to have a lengthy back and forth with the insurer. Now the patient has witnessed the exchange, and you can allow the patient to decide what to do next. The patient could:
ACOFP recognizes that burdensome paperwork requirements are contributing to the physician shortage and are ultimately inhibiting appropriate and accessible patient care, and the call to reduce these unnecessary requirements is one of our 2022 Principles of Healthcare System Reform.
Federal programs from the U.S. Centers for Medicare and Medicaid Services (CMS) like the Medicare Quality Payment Program are intended to improve patient care while reducing spending but unfortunately have also increased the administrative burden on physicians. Other programs—such as the U.S. Centers for Disease Control and Prevention’s Patients Over Paperwork initiative and Meaningful Measures Framework—have attempted to reduce paperwork requirements, and the U.S. Health Resources and Services Administration—through the U.S. Department of Health and Human Services—announced plans to distribute funding intended to strengthen resiliency and address burnout in the healthcare workforce. Despite these measures, ACOFP believes more must be done.
In response to the desire to improve efficiencies to osteopathic family physicians, since late 2020, ACOFP has identified, monitored, and pursued advocacy opportunities, including the following, to address reducing burdensome paperwork requirements:
Hopefully, these activities will give physicians ideas on how to reduce burdensome documentation, alert and educate our elected officials about the difficulties associated with redundant/unnecessary paperwork, and demonstrate to our membership these problems, leading to possible resolution.
ACOFP is a community of current and future family physicians that champions osteopathic principles and supports its members by providing resources such as education, networking and advocacy, while putting patients first.