The AAFP has a long history of acting to improve your personal and professional lives; support and sustain your ability to practice comprehensive family medicine; and ensure you have the tools and resources you need to provide high-quality, value-based patient care. Nowhere is that more evident than in the work the Academy has done―and continues to do―to promote administrative simplification. As the AAFP’s top strategic objective, reducing administrative complexity is being addressed through multiple projects and resources from areas throughout the organization.
According to AAFP membership survey results and qualitative research findings, obtaining prior authorization for medical services and supplies and meeting extensive documentation requirements are the tasks you have said you find most onerous. These activities are unduly time-consuming, costly, and create an unnecessary barrier to care for patients. By interfering with your true mission of providing care to your patients, administrative burden is directly linked to professional dissatisfaction―a known risk factor for burnout.
To tackle the problem, the AAFP has―among other actions―convened an internal, organization-wide team charged with driving a comprehensive set of activities aimed at reducing your administrative burden. This group is bringing to bear the full resources of the Academy―communications, public and private sector advocacy, CME and our research teams―to improve your practice environment by identifying and implementing administrative simplification solutions.
Because family physicians are overburdened by administrative functions, the Academy advocates for legislation and regulatory policy advancing industry-wide administrative simplification. Administrative complexity and regulatory burden are among the top reasons independent practices close and the leading causes of physician burnout, and are significant barriers to achieving the Quadruple Aim. We work to eliminate regulations and processes that add cost and undermine the efficient delivery of high-quality care.
The AAFP and other organizations have developed joint principles for administrative simplification in health care. The principles focus on prior authorization, quality measures and the need for measure harmonization, certification and documentation, and medical record documentation. The goal is to put patients ahead of paperwork.
The Academy pushes to strengthen electronic data exchange, reduce administrative complexity, and remove unnecessary burdens throughout the compliance, claims, and billing processes. We lobby for the swift implementation of administrative simplification provisions in federal and state regulations and continually call on CMS to eliminate aspects of the Medicare and Medicaid programs that are unnecessary, obsolete, or excessively burdensome for clinicians and beneficiaries. At the AAFP’s urging, for example, the agency delayed until 2022 implementation of the burdensome Medicare Appropriate Use Criteria program.
In a win for the AAFP’s push for administrative simplification, CMS announced an indefinite suspension of the Appropriate Use Criteria program’s penalty phase. The move signals acknowledgement of the AAFP’s steady advocacy, including as part of a coalition of medical professional and other groups committed to this goal, to delay implementation of the AUC program and affords lawmakers time to repeal it.
A 2020 AMA survey found that 85% of physicians said prior authorizations (PAs) were a high or extremely high burden, and 90% said PA had an impact on clinical outcomes. Recent AAFP advocacy to reduce and streamline PA includes support of the Improving Seniors’ Timely Access to Care Act (H.R. 3173).
Watch the AAFP Family Medicine Practice Hack video for three strategies to reduce prior authorization burden, and use this member-exclusive prior authorization workbook with cheat sheets to save time in managing your process.
Members cite documentation as a top administrative burden in AAFP Member Satisfaction Surveys. The AAFP Innovation Lab partnered with Suki, a voice-enabled, artificial intelligence (AI)-powered digital assistant, to validate the adoptability of an AI Assistant for Documentation in family medicine. That lab found this essential innovation can reduce physician documentation time by 72%.
A newer lab studied Hint Health’s direct primary care (DPC) membership management solution, HintOS, which saved physicians time by handling prospective membership and payment tasks as they shifted from fee-for-service to a DPC model.
The Academy advocates that electronic health record (EHR) initiatives reduce administrative complexity and maximize patient benefit. The AAFP Innovation Laboratory seeks proven, advanced technological platforms and tools―cloud, AI/machine learning, and others―to support this goal and add member value.
An example: Navina, an AI-driven platform that integrates with a practice's EHR and automates real-time aggregation and analysis of patient data to optimize diagnoses and coding processes and enhance clinical workflow.
As a standing member of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), the AAFP helps shape Medicare relative values, which influence physician payment. Following AAFP recommendations, CMS implemented the first major overhaul of office visit/outpatient evaluation and management (E/M) guidance in more than 25 years on January 1, 2021.
The new guidelines prompted the AAFP to develop a comprehensive collection of information, resources and tools, including this Family Medicine Practice Hack.
To ensure quality measures focus on factors that impact individual and population health, the AAFP released guiding principles to advocate for standardized patient-centric measures. As a founding member and participant of the Core Quality Measures Collaborative, the AAFP is key to developing and revising measure sets that harmonize measurement across payers.
As a long-time champion of the Patient-Centered Medical Home, the AAFP understands that practice change can be daunting, so AAFP TIPS™ has broken the process down into manageable pieces. Designed for family medicine, AAFP 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. Visit the FPM Toolbox for more resources.