CMS Trying to Reduce Physician Paperwork with 2018 Final Rule

CMS Physician Paperwork

When it comes to the changing healthcare landscape, three common words being thrown about these days are “reduce regulatory burden.” And a key goal of physiciansis almost always to reduce the time needed to fill out paperwork so they can put more time and focus on creating thorough documentation for proper reimbursement, and on their patients’ health.

Less Filing, More Patient Time

Executive orders issued by the Trump administration have focused on reducing regulations, and the medical field has not escaped that spotlight. In fact, the Centers for Medicare & Medicaid Services (CMS) spent much of 2017 searching for ways to comply with the administrations’ orders in the agency’s revisions of the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment system for the upcoming calendar year.

CMS typically issues about 58 new regulations annually, causing headaches and additional administrative time for physicians. Modern Healthcare estimates that physicians spend about 49 percent of their time on administrative duties, which is especially no surprise when considering the average physician has contractual relationships with a minimum of seven payers.

In monetary terms, that administrative work translates into about $39 billion per year, or $1,200 with each patient admission into a hospital. By removing certain measures and restrictions, the 2018 CMS policies are geared at cutting down on these costs and helping physicians switch to spending more time with patients.

Streamlining Requirements

Medical compliance expert Jill Young recently explained the upcoming 2018 updates CMS will make to its Medicare policies and directions in an audio conference for ProfEdOnDemand. Young also addressed Medicare code changes, including the HCPCS, CPT® and ICD-10-CM coding systems. The big takeaway is that for 2018, CMS is finalizing provisions it says will do away with regulations that hinder physicians’ effectiveness.

Efforts to reduce administrative burdens on physicians while allowing them more face-to-face time with patients includes a new moratorium on the direct supervision requirements for outpatient therapeutic services located at both critical access hospitals (CAH) and small rural hospitals with 100 or fewer beds. The previous moratorium expired at the end of last year.

Two other key measures are:

  • Removing three Ambulatory Surgical Center Quality Reporting (ASQR) program measures for calendar year (CY) 2019 payment
  • Removing six Hospital Outpatient Quality Reporting (OQR) quality measures


To assist ASCs in reporting quality data without excessive paperwork, and to help them avoid the 2-percent reduction in annual payment updates if data is reported incorrectly, CMS is removing the following three AQSR measures:

  • ASC-5: Prophylactic Intravenous (IV) Antibiotic Timing
  • ASC-6: Safe Surgery Checklist Use
  • ASC-7: ASC Facility Volume Data on Selected Procedures


It’s worth noting that CMS is adding two more measures (ASC-17 and ASC-18), which it says will not encumber physicians with additional paperwork.

 Quality Data in the Spotlight

A third aspect of this initiative regards outpatient hospital services, which also must meet several requirements in order to avoid the 2-percent reduction in annual payment updates. In 2018 CMS says it has attempted to balance quality of data provided with a reduced physician burden by removing six measures:

  • OP-21: Median Time to Pain Management for Long Bone Fracture
  • OP-26: Hospital Outpatient Volume Data on Selected Outpatient Surgical Procedures
  • OP-1: Median Time to Fibrinolysis
  • OP-4: Aspirin at Arrival
  • OP-20: Door to Diagnostic Evaluation by a Qualified Medical Professional
  • OP-25: Safe Surgery Checklist Use

Improving Healthcare for Both Patients and Providers

If proven successful, CMS’s changes could reduce hundreds of thousands of hours and millions of dollars currently being spent by physicians on administrative tasks. This reduction would not only allow for the possibility of money being channeled toward improvements in the healthcare system, but it would also be consistent with the transition in healthcare towards being more patient-centered, as the experience—and not just outcomes—are becoming more important to the survival of physicians’ practices.

To join the conference or see a replay, order a DVD or transcript, or read more

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