AAFP Resources Explore Administrative Simplification

New Webpage, FPM Journal Issue Lend Insight, Offer Solutions

July 16, 2021, 3:48 p.m. News Staff ― When you first started thinking about pursuing a career in family medicine, did you see yourself hunched over a laptop typing into your EHR, or were you reassuring a worried mom that her baby’s sudden fever ― absent other symptoms ― is most likely nothing serious? Did you envision spending hours on the phone trying to convince insurance reps that, yes, your patient does in fact need a medication that’s not on their plan’s formulary, or were you counseling a young teen about the risks of vaping?

Long story short: You didn’t go into medicine to jump through bureaucratic hoops at the expense of caring for patients. Through membership survey results and qualitative research, you’ve made it abundantly clear that reducing administrative complexity is your No. 1 priority. The Academy has heard that directive loud and clear and is committed to finding solutions.

The AAFP’s Principles for Administrative Simplification have been a key driver of that process. Adopted in 2018, the principles were intended to ensure that patients have timely access to treatment while reducing administrative burden on physicians. They cover four specific areas members view as particularly problematic: prior authorization, quality measures and the need for harmonization across measures, certification and documentation, and medical record documentation.

Visit the AAFP’s newly launched Administrative Simplification webpage for a look at how the Academy is working to cut administrative burden. It’s a battle that’s being fought on multiple fronts, and this new resource highlights many of those efforts.

Advocacy: Patients Over Paperwork

Recognizing that administrative complexity and regulatory burden are among the top drivers of independent practice closures and the chief causes of physician burnout, the AAFP advocates for legislative measures and regulatory policy that advance industry-wide administrative simplification.

Story Highlights

Specifically, the Academy has called for bolstering electronic data exchange and removing needless burdens that plague the compliance, claims and billing processes, including by urging CMS to eliminate aspects of the Medicare and Medicaid programs that are unnecessary, obsolete or excessively burdensome for family physicians and their patients. Similar efforts are being pursued with private payers.

Those efforts are seeing results: Ongoing AAFP advocacy to ease prior authorization requirements has prompted CMS to propose that certain health plans automate prior authorization processes. Academy input is also reflected in CMS’ decision to delay implementation of the burdensome Medicare Appropriate Use Criteria program until 2022. (And work continues to halt implementation of the AUC program altogether.)

Administrative Simplification in Practice

The new web resource highlights other ways the AAFP is working to cut members’ administrative burden, focusing on activities, tools and programs that seek to tackle specific aspects of the problem.

Reduce and Streamline Prior Authorization: The Academy has joined with more than a dozen other medical specialty groups to support the Seniors’ Timely Access to Care Act  (H.R. 3173), which would ease prior authorization requirements in the Medicare Advantage program and likely drive welcome and badly needed improvements to prior authorization in commercial insurance plans.
Reduce Charting Time: The AAFP has partnered with Suki, a tool powered by artificial intelligence that acts as the physician’s digital assistant for documenting patient visits. Suki has demonstrated that it cuts in-clinic documentation time in half and after-hours charting by 70%.
Improve EHR Usability: The AAFP Innovation Laboratory seeks proven, advanced technological platforms and tools to reduce administrative complexity and add member value. One example is Navina, an AI-driven platform that integrates with a practice's EHR and automates real-time aggregation and analysis of patient data to optimize diagnosis and coding and enhance clinical workflow.
Simplify E/M Coding & Documentation: As a standing member of the AMA/Specialty Society Relative Value Scale Update Committee, the AAFP helps shape Medicare relative values, which, in turn, influence physician payment. In addition, CMS took Academy recommendations into account when it implemented the first major overhaul of office visit/outpatient evaluation and management (E/M) guidance in more than 25 years on Jan. 1, 2021.
Champion Meaningful Quality Measures: As a founding member and active participant of the Core Quality Measures Collaborative, the AAFP is key to developing and revising measure sets to harmonize quality measurement across payers. The AAFP is also represented on the Measure Applications Partnership, which guides CMS in selecting performance measures for federal health programs.
Facilitate Practice Improvement: Practice change can be daunting, so AAFP TIPS™ has simplified the process. Designed for family medicine, TIPS resources make preparing your team for practice improvement faster and easier. Multiple TIPS options let you choose which practice areas to work on, and customizable, ready-to-use tools help you make small changes that yield big results ― all at no charge to members.

FPM Journal Focus

Finally, the July/August issue of FPM is largely devoted to administrative simplification, with how-to articles on a range of related topics, including “Practical Ways to Manage Your EHR Inbox,” “FMLA Does Not Need to Be a Four-Letter Word” and “A Step-by-Step Time-Saving Approach to Coding Office Visits.”

Also in the issue, FPM Editor Sarina Schrager, M.D., M.S., provides insight into her office’s experiences with onerous clerical tasks and other practice hassles and outlines how she and her team are working to lessen the load. And in another feature, AAFP staff experts offer a roundup of what the Academy is doing to tackle administrative complexity.