CMS wants docs to spend more time on patients, less on paperwork

The CMS launched an initiative Thursday to help it determine what provider regulations it should junk or revamp, citing growing concerns that its regulations are reducing the time providers spend with patients.

As part of the Patients over Paperwork initiative, CMS officials will travel the country to gather information on the impact their regulations have on physicians. Those conversations have been taking place informally for weeks.

The outreach effort comes at a time that primary-care physicians are spending 27% of their time on clinical activities and 49% on administrative activities, according to a 2016 Annals of Internal Medicine study. The CMS now releases around 58 rules, or 11,000 pages of regulation, each year.

CMS Administrator Seema Verma said she consistently hears that meaningful use requirements, which measure how well providers are using health IT, are far too burdensome without offering much benefit, and quality measures tied to various pay models need to be rethought to ensure they are actually leading to better care and lower costs.

"We've laid out this vision of moving away from fee for service to quality, but as you get into the details of what that means … how do we actually measure that?" Verma said at the initiative launch. "Does the burden of reporting quality measures outweigh their utility."

Verma said she agrees with industry that the agency needs to develop a smaller set of measures that track better health outcomes and quality of care versus those that focus on process.

Physicians will see examples of the agency's commitment to rolling back regulations as soon as next week when the final rule that implements the second year of the MACRA rollout is expected to be released, Verma said, though she didn't provide any specifics on the rule.

The new initiative was announced one day after the American Hospital Association released a report about the regulatory burden its members face.

Hospitals, health systems and post-acute care providers spend nearly $39 billion a year on administrative activities related to regulatory compliance, according to the study. That translates into $1,200 every time a patient is admitted to a hospital.

AHA was one of the 35 trade groups representing providers and medical practices that attended the initiative's launch at HHS' D.C. headquarters Thursday.

"There is growing frustration for those on the front lines providing care in a system that often forces them to spend more time pushing paper rather than treating patients," AHA CEO Rick Pollack said at the event.

Pollack specifically asked HHS to loosen anti-kickback policies that can impede needed partnerships for value-based models, and said HHS needs to rethink its claims audit process, which now leads to erroneous findings that are often overturned on appeal.

Doctors want greater harmonization of regulatory requirements between Medicare and other payers, according to Dr. Michael Munger, president of the American Academy of Family Physicians, who was attended the event. The average family physician has a contractual relationship with seven or more payers and 38% have contractual relationships with more than 10 payers.

Providers have to comply with multiple quality programs, prior authorization and health IT requirements all at the same time.

"This effort comes at a critical time for our healthcare system," Munger said at the event. "The volume of administrative and regulatory functions required of physicians is compounded by the lack of harmonization in these functions across payers."