Administrative Simplification
Prior Authorization
Prior authorization continues to be a leading cause of physician burden. Time-consuming administrative processes encumber family physicians, divert valuable resources from direct patient care, and delay the start or continuation of necessary treatment. This leads to lower rates of patient adherence to treatment, as well as negative clinical outcomes.
The AAFP fiercely drives efforts to reform prior authorization and remains focused on enabling physicians and patients to have access to clear guidelines for prior authorization requirements and timely responses from insurance plans.
The AAFP advocates for legislation and regulatory policy that relieve administrative complexity and put patients ahead of paperwork. Learn about recent advocacy wins affecting prior authorization and keep track of our activity.
Reduce the frequent phone calls, faxes, and forms that add to your day by exploring the below tools aimed at saving time on prior authorization.
Payment
Primary care physicians must be adequately compensated for their services without increasing administrative complexity. That's why the Academy continues to advocate on behalf of family physicians to ensure that commercial payers as well as Medicare and Medicaid reimbursements appropriately reflect the costs of clinical services and the new duties and responsibilities primary care physicians are taking on in a reform-driven environment.
The Academy works to ensure that all payers recognize the true scope of practice delivered by family physicians: comprehensive, longitudinal care across every patient population, diagnosing and managing a wide range of conditions. The AAFP advocates to secure the best possible reimbursements and to advance the payment models of the future.
From small changes that embrace innovative payment models to full practice transformation, explore tools and insights that will reduce the challenges that come with being fairly and sustainably paid.
Documentation and Coding
You devote significant time and resources to documenting patient visits electronically, then finding all the appropriate billing codes—time and resources that would be better dedicated to patient care. Central to the Academy’s fight for administrative simplification is our advocacy to simplify documentation requirements across payers while pushing for improvements to electronic health records and driving innovations to reduce documentation burden and time.
Primary care physicians face increasing administrative complexity even as compensation has lagged. To meet these interwoven challenges and bring crucial growth to the specialty, the Academy advocates constantly to ensure the best possible Medicare and Medicaid reimbursements, advance the payment models of the future, and improve interoperable data sharing to reduce physicians’ manual work.
Reduce the amount of time you spend on documentation and coding with these tools and overviews.
Quality Measures
Your practice may submit claims to more than 10 payers, a burden the Academy is working to reduce by advocating for the adoption of a single set of quality measures across all public and private payers. Some of our key efforts toward this critical need include AAFP guiding principles for standardized patient-centric measures and our development, as a founding member and participant of the Core Quality Measures Collaborative, of new and revised measure sets designed to harmonize across payers. The AAFP is also part of the Measure Applications Partnership, which guides CMS in selecting performance measures for federal health programs.
It’s the Academy’s position that the adoption of a single set of meaningful quality measures across all public and private payers is critical. Additionally, payers must shift to more patient-centric evidence-based outcomes measures and away from disease-specific process measures.
Apply quality measures that recognize the value you provide.
Tell Us More
You can help us shape our evolving resource library. Use this form to tell us what administrative tasks and challenges you’d like to learn more about.