Internists Make Recommendations at Meeting With HHS Secretary

06/28/2017
The American College of Physicians (ACP) today told a meeting convened by Health and Human Services (HHS) Department Secretary Tom Price that it has long identified reducing excessive administrative tasks as an important objective. The purpose of the meeting was to evaluate the impact of government requirements on the clinician-patient relationship.  
The meeting included representatives from five other health care organizations which all touted similar recommendations.
This year, ACP published the position paper, Putting Patients First by Reducing Administrative Tasks in Health Care. The paper is a fundamental underpinning of the ongoing ACP “Patients Before Paperwork” initiative, as it outlines a cohesive framework for analyzing administrative tasks and recommends ways to mitigate or eliminate their adverse effects on physicians, their patients, and the health care system as a whole. This initiative also includes the pursuit of a path forward such that care and clinical documentation in the 21st century best serve the needs of patients and families, as outlined in a 2015 policy paper titled Clinical Documentation in the 21st Century.
At the HHS meeting today, ACP strongly recommended removing the history and examination requirements from both the 1995 and 1997 Evaluation & Management (E&M) guidelines. However, “we recommend that the medical decision-making portion of [these] guidelines be retained and tied to program integrity,” said ACP representative Michael S. Barr, MD, MACP, senior vice president of the National Committee for Quality Assurance and member of the ACP Medical Informatics Committee.  “Specialty societies would work with the Centers for Medicare and Medicaid Services (CMS) to create documentation frameworks specific to each specialty based on key principles to support health care instead of accounting.”
“Documentation must support caring for the people who entrust their lives to us,” said Dr. Barr. “We must move away from the mindset that documentation equals reimbursement.”
Dr. Barr also emphasized that “clinical documentation in electronic health record (EHR) systems must support clinicians’ cognitive processes during the documentation process and provide all who engage in the care of a patient access to accurate, concise information upon which they can rely and use.”
ACP further recommended that HHS designate chronic care management (CCM) services as “additional preventive services” available under Medicare Part B through its waiver authority of the Social Security Act in order to eliminate any beneficiary co-payment associated with CCM services.
“This recommendation is also related to improving care,” said Brian Outland, ACP’s director of Regulatory Affairs.  “Many Medicare beneficiaries with complex conditions – high-need, high-cost individuals – are not benefiting from chronic care management services that we know are associated with better quality and lower cost.  This is in large part because of the 20 percent copay requirement.” 
While Secretary Price did not cite a timeline for reacting to recommendations, he did note the importance of working with stakeholders.