Action Plan to Reduce Excessive Administrative Tasks in Health Care March 30, 2017 ACP Medical Practice & Quality Committee Shari M. Erickson, MPH, Vice President, Governmental Affairs and Medical Practice

Overview of Action Plan Policy Development Advocacy Letters Collaborations - Webinars and Listening Sessions Reducing Administrative Burden Toolkit

Patients Before Paperwork Web Page Link: https://www.acponline.org/advocacy/where-we-stand/patients-before-paperwork

Policy Development “Putting Patients First by Reducing Excessive Administrative Tasks in Health Care: A Position Paper of the American College of Physicians,” Ann Intern Med. Online First March 28, 2017. "Clinical Documentation in the 21st Century," Ann Intern Med. Online First February 17, 2015. Medicare Advantage (MA) Policy Development: The College is developing policy recommendations to: Align administrative policies across all MA plans to address any additional, unnecessary administrative burdens associated with participating in the MA program Promote transparency among MA plans regarding the intent of plan- specific requirements so that physicians can provide the same high- quality care to all patients regardless of the type of MA plan

Advocacy Letters Formal letters from ACP leadership to external stakeholders outlining framework and policy recommendations Initial set of external stakeholders: America’s Health Insurance Plans (AHIP) Blue Cross Blue Shield Association (BCBSA) Electronic Health Record Association (EHRA) Medical Device Manufacturers Association (MDMA) Centers for Medicare and Medicaid Services (CMS) Office of the National Coordinator for Health IT Medicare Payment Advisory Commission (MedPAC) Additional regulatory and legislative advocacy efforts to follow

Collaborations Alignment with ACP’s broader efforts to promote physician wellness With external stakeholders: Webinars and Listening Sessions to discuss types of administrative tasks faced by practicing clinicians and identify best practices and solution to reduce/streamline/eliminate excessive administrative tasks Key Stakeholder Groups Invited Include: AHIP, BCBSA, EHRA, MDMA, CMS, ONC, etc.

Reducing Administrative Burden Toolkit Reducing Administrative Burden Basics – Two-Pager and PowerPoint Presentations: Can be used at local ACP Chapter meetings and educational opportunities COMING SOON: Individual Advocacy: Letter template for individual members to contact external stakeholders identified as sources of administrative burden Administrative Burdens Library: Repository of internal and external administrative and regulatory burdens and best practices Also, Existing ACP Practice Resources…

Reducing Administrative Burden Toolkit: Existing ACP Practice Resources

Reducing Administrative Burden Toolkit: Existing ACP Practice Resources

Reducing Administrative Burden Toolkit: Existing ACP Practice Resources

Feedback Welcome! The Reducing Administrative Burden Action Plan will continue to evolve as new issues and opportunities arise We welcome your feedback and any suggestions you may have for future action Please email policy-regs@acponline.org with suggestions or specific examples to add to the Administrative Burden Library

Supplemental Slides

Figure 1: A Framework for Analyzing Administrative Tasks

ACP Policy Recommendations: Stakeholders who develop or implement administrative tasks should provide financial, time, and quality of care impact statements for public review and comment. Tasks that cannot be eliminated must be regularly reviewed, revised, aligned and/or streamlined with the goal of reducing burden Stakeholders should collaborate to aim for performance measures that minimize unnecessary burden, maximize patient- and family-centeredness, and integrate measurement of and reporting on performance with quality improvement and care delivery Stakeholders should collaborate in making better use of existing health IT, as well as develop more innovative approaches. As the US health care system evolves to focus on value, stakeholders should review and consider streamlining or eliminating duplicative administrative tasks Rigorous research is needed on the impact of administrative tasks on our health care system Research on and dissemination of evidence-based best practices to help physicians reduce administrative burden within their practices and organizations

Figure 2: Taxonomy of Administrative Tasks External to the Practice & Health Care Environment Legend: Each circle indicates a characteristic of an administrative task Administrative tasks in these categories are worthwhile Administrative Tasks in these categories require careful consideration of alternatives ? Administrative tasks in these categories should be eliminated - This figure illustrates Policy Recommendation #1 - Stakeholders who develop or implement administrative tasks should provide financial, time, and quality of care impact statements for public review and comment.