The Centers for Medicare and Medicaid Services’ (CMS) new
initiative to reduce the paperwork burden on doctors and patients, deemed Patients Over Paperwork, is remarkably similar to ACP’s campaign, called Patients
Before Paperwork, to
accomplish the same. Whether the agency was directly inspired by
ACP’s campaign, down to coming up with an almost identical name for it, or came
up with a similar moniker on its own, what matters is that the message ACP has
been pushing for more than two years now, that doctors are being squeezed by
unnecessary administrative tasks that take time away from patients, is being
heard now at the highest reaches of the federal government. What I do know is that prior to CMS’ launch
of the initiative last week, ACP has held several meetings with and previously
wrote to CMS officials pressing our recommendations to reduce unnecessary
regulations and other administrative tasks.
In her
remarks yesterday to the Health Care Learning and Action Network Fall
Summit, CMS Administrator Seema Verma explained what CMS hopes to accomplish
from Patients Over Paperwork:
Since assuming my role at CMS, we
are moving the agency to focus on patients first. To do this, one of our top
priorities is to ease regulatory burden that is destroying the doctor-patient
relationship. We want doctors to be able to deliver the best quality care to their
patients.
We often hear about this term –
“regulatory burden” – but what does it actually mean? Regulations have
their place and are important to ensuring quality, integrity, and safety in our
health care system. But, if rules are misguided, outdated, or are too complex,
they can have a suffocating effect on health care delivery by shifting the
focus of providers away from the patient and toward unnecessary paperwork, and
ultimately increase the cost of care.
I saw this during a recent trip to
Hartford, Connecticut, where I met with providers.
One told me
she was going to close her practice after decades in medicine because spending
so much time away from her patients doing paperwork just wasn’t worth it for
her anymore.
In Cleveland, Ohio, I heard a story
of a physician who was overwhelmed by having to personally fax patient
records…in 2017 we are still faxing patient records. Just thinking about that
frustrates me…having to do it, I’m sure is even worse.
Doctors are frustrated because they
got into medicine to help their patients. But, paperwork has distracted them
from caring for their patients, who often have waited weeks, if not months, for
the brief opportunity to see them.
We have all felt this squeeze in
the doctor’s office…we have all seen our doctors looking at a computer screen
instead of us. I hear it from patients across the country. This must change.
The primary focus of a patient
visit must be the patient. Just last week, CMS announced our new
initiative “Patients Over Paperwork” to address regulatory burden. This is an
effort to go through all of our regulations to reduce burden. Because when
burdensome regulations no longer advance the goal of patients first, we must
improve or eliminate them.
At CMS, our overall vision is to
reinvent the agency to put patients first. We want to partner with patients,
providers, payers, and others to achieve this goal. We aim to be responsive to
the needs of those we serve. We can’t do that if we’re simply telling our
partners what to do—instead of listening and—most importantly—having our
policies be guided by those on the
front lines serving patients.
Touche! ACP couldn’t
have said it better. Today, we sent a letter
to Administrator Verma to pledge our support for her Patients Over Paperwork initiative. We shared with her our
policy paper, Putting
Patients First By Reducing Administrative Tasks in Health Care, which
proposes an entirely new framework to evaluate the intent and impact of
existing or proposed new tasks, so that those that are not justified by their
intent, or that have such an adverse impact on doctors and patients that they
cannot be justified even if the original intent is sound, can be challenged and
then eliminated or at least ameliorated.
We urged that CMS adopt this framework to evaluate its own regulations
and administrative tasks.
ACP’s letter also advised her that we were encouraged by her
announcement of a new “Meaningful Measures” initiative to ensure that quality
measures, which are a critical component of paying for value, are streamlined,
outcomes-based, and truly meaningful to clinicians and their patients. This initiative appears to be well aligned
with ACP's comments
to CMS last year on the Quality Measure Development Plan.
Whether it is putting patients before or above
paperwork—both are needed—it is great news for doctors that ACP’s two-year plus
campaign to reduce administrative tasks on physicians has found support in the
highest reaches of government, coming from the head of an agency, CMS, that can
do more to ease red tape than any other.
Today’s question: if you were CMS Administrator Verma, what
is the first Medicare administrative task you would recommend she review?
