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.
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.
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.
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.