AAFP Sustains Fight to Reduce Administrative Burden for Family Medicine

The AAFP recently ramped up efforts calling for an immediate reduction in the regulatory and administrative requirements family physicians and practices must comply with on a daily basis. These burdens range from onerous documentation guidelines to cumbersome prior authorization criteria and the unrelenting frustrations associated with electronic health records. Among the AAFP’s activities:

In early 2017, the AAFP published its Agenda for Regulatory and Administrative Reforms. Family physicians are concerned with the ever increasing number of administrative requirements that detract from time that would be better spent on patient care. Studies have estimated that primary care physicians spend nearly 50 percent of their time on overly cumbersome administrative tasks, such as:

  • Prior Authorizations
  • Performance Measures and Reporting
  • Electronic Health Record Documentation
  • Care Management Documentation

Prior-authorizations top the list of physician complaints about administrative burden. On Jan. 25, the AAFP and a coalition of 16 other medical organizations called for the reform of prior authorization and utilization management requirements that bog down physicians and impede patient care. Through its "Prior Authorization and Utilization Management Reform Principles(www.ama-assn.org)," the coalition is "urging health insurers and others to apply the reform principles and streamline requirements, lengthy assessments and inconsistent rules in current prior authorization programs."


A 2016 study published in the Annals of Internal Medicine found that during a typical day, primary care physicians would spend 27 percent of their time on clinical activities and 49 percent on administrative activities. The authors of the study, “Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties(annals.org),” concluded that for every hour primary care physicians spends in direct patient care, they spend two hours engaged in administrative functions.

The AAFP’s advocacy efforts to alleviate family physicians from undue administrative complexity are ongoing, as demonstrated by recent letters to the Trump administration and CMS.

A December 16, 2016, letter from the AAFP to acting CMS Administrator, Andy Slavitt, expresses concern about patient relationship categories and related coding documentation required under the Medicare Access and CHIP Reauthorization Act. The requirement will significantly increase the administrative burden that Medicare participating physicians already experience.

A January 31, 2017, letter from the AAFP to President Trump cites research demonstrating how family physicians face a regulatory burden that is unmatched among the various medical disciplines.

On March 21, 2017, the AAFP and nearly 90 other medical organizations sent a letter to CMS Administrator, Seema Verma, calling for the agency to establish a strategy to relieve the electronic health record documentation burden. The letter also called on CMS to create a hardship exemption for physicians who attempted to report PQRS in 2016 but were unsuccessful due to the complexity of the reporting requirements and the significant number of measures that were required.

In an April 26, 2017 letter from the AAFP to CMS Administrator, Seema Verma, the AAFP notes its support of President Trump’s executive order, Reducing Regulation and Controlling Regulatory Costs, but calls for CMS to step back and reconsider the current approaches to the Medicare Access and CHIP reauthorization Act of 2015 (MACRA), which we view as overly complex and burdensome to physicians.