[{"innerBlocks":[],"name":"core\/freeform","postId":490,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"The prior authorization process must be improved by streamlining and standardizing procedures, and it needs better integration with electronic health record systems.That\u2019s the message physician groups delivered to the House Small Business Committee last week during a hearing on reducing the burden of prior authorization on small medical practices. A major problem with prior authorization\u2014a process by which health insurers require doctors to first obtain approval before conducting a procedure or prescribing a medication\u2014is that it \u201cinvolves varying forms, data elements and submission mechanisms that force physicians to enter unnecessary data in the EHR or perform duplicative tasks outside the clinical workflow,\u201d contends the American College of Physicians.\u201cPhysicians should not be required to log into a separate portal to access the software,\u201d testified Howard Rogers, MD, on behalf of the American Academy of Dermatology Association. \u201cA separate portal often requires the physician to re-enter the medical information or transfer the data, often taking time away that could be spent with patients.\u201d

Rogers said AADA wants the Centers for Medicare and Medicaid Services to require plans to offer electronic prior authorization transactions that are integrated into prescribers\u2019 EHRs.At the same time, he commended CMS and Congress \u201cfor building on their previous efforts to require Medicare Advantage and Part D prescription drug plans to provide doctors with real-time access to drug pricing data via EHR or prescribing software, so physicians are informed of beneficiary-specific drug coverage and cost information.\u201dIn a memo sent to members of the House Small Business Committee in advance of the hearing, Chair Nydia Vel\u00e1zquez (D-N.Y.) made the case for making prior authorization requirements and other formulary information electronically accessible to healthcare providers at the point of care in EHRs, as well as moving toward an industry-wide adoption of electronic prior authorization transaction based on national standards.\u201cIncluding all this information electronically in EHR systems will improve process efficiencies, reduce time to treatment and potentially result in fewer prior authorization requests because healthcare providers will have the coverage information they need when making treatment decisions,\u201d states the memo.John Cullen, MD, testifying on behalf of the American Academy of Family Physicians, cited a 2019 AAFP member survey that found that the highest priority for the AAFP is to reduce physicians\u2019 administrative and regulatory burden. \u201cFully 74 percent of respondents said the time spent on administrative tasks has increased since 2018,\u201d said Cullen in his testimony. \u201cThey cite the greatest administrative burdens as those associated with electronic health record documentation, prior authorization and quality measure reporting.\u201dAccording to Cullen, prior authorization for prescription drugs was an administrative burden reported by 88 percent of respondents in the AAFP survey, while 79 percent of members indicated that prior authorization for procedures\u2014including imaging\u2014was a burden.\u201cMost troubling is that 84 percent reported that the amount of time they personally spent on administrative functions and tasks associated with patients\u2019 care has increased in the past three years,\u201d noted Cullen. \u201cThis is a serious problem that is getting worse.\u201dRogers, who is a board-certified dermatologist and owns a small private practice, said his practice has hired two full-time staff at a cost of $120,000 per year to handle the volume of prior authorizations. \u201cEven with extra support staff, providers in my practice are regularly disrupted from patient care to deal with prior authorizations,\u201d he testified. \u201cOne quarter of my office\u2019s communications\u2014be it phone calls, faxes, emails or notifications from EHRs or payer portals\u2014are associated with prior authorizations.\u201d","saveContent":"The prior authorization process must be improved by streamlining and standardizing procedures, and it needs better integration with electronic health record systems.That\u2019s the message physician groups delivered to the House Small Business Committee last week during a hearing on reducing the burden of prior authorization on small medical practices. A major problem with prior authorization\u2014a process by which health insurers require doctors to first obtain approval before conducting a procedure or prescribing a medication\u2014is that it \u201cinvolves varying forms, data elements and submission mechanisms that force physicians to enter unnecessary data in the EHR or perform duplicative tasks outside the clinical workflow,\u201d contends the American College of Physicians.\u201cPhysicians should not be required to log into a separate portal to access the software,\u201d testified Howard Rogers, MD, on behalf of the American Academy of Dermatology Association. \u201cA separate portal often requires the physician to re-enter the medical information or transfer the data, often taking time away that could be spent with patients.\u201d

Rogers said AADA wants the Centers for Medicare and Medicaid Services to require plans to offer electronic prior authorization transactions that are integrated into prescribers\u2019 EHRs.At the same time, he commended CMS and Congress \u201cfor building on their previous efforts to require Medicare Advantage and Part D prescription drug plans to provide doctors with real-time access to drug pricing data via EHR or prescribing software, so physicians are informed of beneficiary-specific drug coverage and cost information.\u201dIn a memo sent to members of the House Small Business Committee in advance of the hearing, Chair Nydia Vel\u00e1zquez (D-N.Y.) made the case for making prior authorization requirements and other formulary information electronically accessible to healthcare providers at the point of care in EHRs, as well as moving toward an industry-wide adoption of electronic prior authorization transaction based on national standards.\u201cIncluding all this information electronically in EHR systems will improve process efficiencies, reduce time to treatment and potentially result in fewer prior authorization requests because healthcare providers will have the coverage information they need when making treatment decisions,\u201d states the memo.John Cullen, MD, testifying on behalf of the American Academy of Family Physicians, cited a 2019 AAFP member survey that found that the highest priority for the AAFP is to reduce physicians\u2019 administrative and regulatory burden. \u201cFully 74 percent of respondents said the time spent on administrative tasks has increased since 2018,\u201d said Cullen in his testimony. \u201cThey cite the greatest administrative burdens as those associated with electronic health record documentation, prior authorization and quality measure reporting.\u201dAccording to Cullen, prior authorization for prescription drugs was an administrative burden reported by 88 percent of respondents in the AAFP survey, while 79 percent of members indicated that prior authorization for procedures\u2014including imaging\u2014was a burden.\u201cMost troubling is that 84 percent reported that the amount of time they personally spent on administrative functions and tasks associated with patients\u2019 care has increased in the past three years,\u201d noted Cullen. \u201cThis is a serious problem that is getting worse.\u201dRogers, who is a board-certified dermatologist and owns a small private practice, said his practice has hired two full-time staff at a cost of $120,000 per year to handle the volume of prior authorizations. \u201cEven with extra support staff, providers in my practice are regularly disrupted from patient care to deal with prior authorizations,\u201d he testified. \u201cOne quarter of my office\u2019s communications\u2014be it phone calls, faxes, emails or notifications from EHRs or payer portals\u2014are associated with prior authorizations.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Providers: Prior authorization needs to be better integrated with EHRs

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