Reducing healthcare's administrative burden

Nobody likes paperwork, but practicing medicine requires a lot of it. Between EHR documentation, inbox management, prior authorizations, and other clerical tasks, it’s a wonder physicians have time to care for patients. Healthcare’s administrative burden is taking a toll, but promising efforts are underway to reduce the load.

Administrative Burden Costs Everyone

Before looking at how to reduce healthcare’s administrative burden, it’s essential to understand its cost. Consider the latest data about physician burnout and time spent on paperwork:

  • Across specialties, physicians spend on average 15 hours per week on paperwork and administration (up significantly from a decade ago)
  • In surveys, physicians consistently say “paperwork” is their least favorite part of their work
  • The average doctor spends nearly half of their work time (45%) interacting with the EHR
  • Across a range of national surveys, over half of physicians report burnout symptoms

Physicians are constantly under pressure to provide quality care. Now, they face growing demands associated with documentation and regulatory compliance. Administrative complexity has led to record levels of physician burnout, which negatively impacts medical professionals and their families.

Healthcare’s administrative burden also affects patients. Not only do burnt-out physicians struggle to provide the best care, but administrative barriers limit patients’ ability to access care. In a recent survey, nearly one-quarter of patients say they delayed or forewent care due to administrative tasks.

Clinicians can take steps to reduce their time spent on paperwork, such as implementing efficiency habits or streamlining clinical documentation. However, without systemic changes, individual action is an uphill battle. So, what are governments, professional organizations, and healthcare systems doing to address the healthcare administrative burden?

Efforts to Address Administrative Burdens in U.S. Healthcare

Professional organizations like the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP) have prioritized working with the government and health systems to simplify healthcare administration. Specifically, they are making progress around prior authorization, EHR functionality, and E/M coding.

Fixing Prior Authorization

The Challenge: Prior authorization processes are notoriously time-consuming for medical staff and often delay patient care.

What’s Being Done: AMA, AAFP, and others identified prior authorization as a key administrative burden. Following their advocacy, a 2024 CMS rule requires government-regulated health plans to shorten the timeframes for prior authorization decisions. The AMA has also promoted model legislation at the state level, resulting in ten new state laws in 2023 and more than a dozen bills before state legislatures this year. 

The Improving Seniors’ Timely Access to Care Act of 2024 has widespread bipartisan support and backing from over 500 organizations. The act, currently pending before Congress, would codify many elements of the CMS regulation while empowering the agency to take further steps to prevent care delays and improve transparency.

What’s Next: Future efforts will focus on further legislative initiatives to enhance and expand prior authorization reforms. Ensuring effective implementation and monitoring of these laws will be essential.

Improving EHR Usability and Interoperability

The Challenge: Physicians have complained that EHRs are cumbersome since digital records became widespread in the early 2010s. Today, interoperability challenges persist, and doctors still spend a disproportionate amount of time on data entry rather than patient care. Many physicians see EHRs primarily as data storage solutions rather than powerful clinical tools.

What’s Being Done: The 2016 21st Century Cures Act mandated important improvements in the interoperability and usability of EHRs by establishing specific usability standards. As a result, organizations are investing in technology that complies with the FHIR standards to facilitate better data exchange. Health Information Exchanges (HIEs) are also expanding, promising to improve care coordination and reduce redundant testing and procedures.

What’s Next: Software developers continue to improve the EHR user experience and are increasingly incorporating AI to automate administrative tasks and clinical documentation. Enhancing interoperability remains a priority, and industry leaders are coming together to find solutions for more seamless healthcare data exchange.

Simplifying E/M Coding

The Challenge: Evaluation and Management (E/M) coding and documentation requirements are complex and time-consuming, adding to the administrative workload of physicians.

What’s Being Done: The AMA, CMS, and other organizations have worked to simplify E/M coding and documentation requirements, making them more clinically relevant and less burdensome. Significant changes include:

  • 2021: Major revisions to the office visit E/M guidelines.
  • 2023: Further revisions to national guidance for inpatient E/M coding, including updated CPT code descriptor times, revised guidelines for levels of medical decision-making (MDM), and the option to choose between MDM or time to select code level.
  • 2024: Additional refinements by the CPT Editorial Panel, such as eliminating references to specific time ranges and introducing a minimum time requirement when using time to select a level of E/M service.

What’s Next: Continued updates and refinements to E/M coding guidelines are expected to continue supporting administrative simplicity. Ongoing healthcare provider education will help ensure a smooth transition and effective implementation of the new standards.

The Role of Physicians

As a physician, you play a crucial role in supporting system-level efforts to reduce administrative burdens. You can advocate for policy changes, provide feedback on EHR systems, stay informed about new regulations, adopt cutting-edge clinical documentation solutions, or share ideas and best practices with colleagues.

Taking small, occasional actions will increase your efficiency and create a more supportive and efficient healthcare system. 

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