Massachusetts Medical Society: Administrative Burdens

Administrative Burdens

Admin Burden


THE ISSUE:

Physicians of the Commonwealth are committed to excellent, timely care for their patients. Unfortunately, administrative complexity in the health care system can impede this goal, putting patients at risk and causing additional stress to health care providers. Physician practices and health systems spend significant time and expense to address administrative complexities, which diverts resources that could otherwise be invested in valuable patient care.

Prior authorizations often delay timely care and reduce access to medical services. “Fail-first” policies create stress for patients and additional administrative tasks for physicians. Excessive documentation and quality measure reporting requirements cause critical patient-specific information to be lost.

Doctors are at the forefront of a changing technological landscape. Electronic Health Records (EHR) represent an opportunity to streamline administrative processes and strengthen the continuity of care; however, implementation of electronic records systems has proved challenging. On average, physicians spend two hours on EHRs and administrative work for every hour of direct patient care.

Administrative complexities can substantially impact care quality and the patient-physician relationship while driving up health care costs. Additionally, these administrative burdens can impede on a physician’s ability to do what they have been well-trained to do: practice medicine.

OUR STANCE:

The Massachusetts Medical Society works to address concerns about requirements, regulations, and implementation that arise in the medical field with approaches that prioritize patient safety and physician autonomy.

The MMS believes that legislative and regulatory systems should facilitate the changes needed for the twenty-first-century health care delivery system and allow for the flexibility and modifications necessary to support health care professionals and organizations who seek to accomplish safe, effective, patient-centered care that is delivered in a timely and equitable manner.

The MMS supports the use of clinical data repositories, as they are beneficial for patients and physicians to improve the quality, safety, efficiency, and value of medical care. Technology enacted to ease administrative burdens should facilitate standards-based data exchange, interoperability, and ease of use, which will serve to promote and enhance the physician-patient relationship.

Thoughtful consideration should be given to rules and regulations related to prescribing, care delivery, and quality controls to ensure that the administrative needs associated with new rules do not unduly burden physicians and others in the medical community.

The MMS supports:

  • Physician inclusion in the EHR development and usability improvement processes
  • Applications with interoperability with most EHR systems so that customized workflow and interfaces can be tailored to different practices
  • Development of Artificial Intelligence (AI) technology that would support clinical documentation and quality measurement
  • Eliminating duplicative and extraneous requirements that do not support care
  • Reducing the total number of clicks, in-basket demands, and other extraneous measures
  • Reducing the total number of quality measures collected by all health plans, as well as employers and all ACOs/APMs in the state, to no more than 10, and adopting the State Quality Alignment Task Force’s core measure set
  • Claims information serving as the primary source for extracted quality data
  • Advocacy with health plans and government entities to consider the costs of implementing EHR technology and its maintenance
  • Improving the functionality and value of EHRs for physicians and their patients, with the goal of enhancing health care quality, safety, and efficiency
  • Implementation of EHRs that feature user-friendly interface, interoperability, data portability, health IT data exchange testing, and provide systems to report quality and performance measures

CURRENT ADVOCACY:

The MMS is working with the AMA and relevant stakeholders to monitor the care quality, access, workforce, population health, and fiscal impacts of electronic medical record implementation nationally and in Massachusetts.

The Medical Society is an active part of a state coalition focused on addressing the issues surrounding prior authorizations and other administrative complexities. MMS has also developed a legislative strategy to meaningfully address prior authorizations, through specific issue-based legislation to call for prior authorization prohibitions, through trying to increase general safeguards for the prior authorization process, and through innovative ideas such as requiring insurance companies to post all drug formularies with prior authorization information.

New electronic prescribing regulations in Massachusetts require all prescriptions to be transmitted through a federally compliant electronic prescribing system starting January 1, 2021. MMS was concerned that the initial proposed regulatory scheme was inflexible, overly complex, and unnecessarily included commonly prescribed “non federally-controlled” drugs. MMS presented testimony about these regulations and the burdens they may cause for physicians. MMS is pleased to report that revised regulations significantly addressed MMS’ concerns.

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