How policies have made clicks the cornerstone of patient care

Close your eyes and imagine you are at work. What do you hear?

For physicians and other healthcare practitioners, where conversation-centered care once defined their workplace, keyboard and mouse clicks have become the unofficial soundtrack for healthcare appointments.

As a result of a government policies, insurance plan coding and electronic health record (EHR) technology, clinicians – particularly those in primary care offices – must document nearly every move they make. In the eyes of these regulators, clinician clicks make sure they can support diagnoses and treatment plans, justify reimbursement, and satisfy quality metrics.

The impact of documentation requirements is not a small one. Experts have noted an increase in “pajama time” as clinicians are forced to allot personal time keeping up with the documentation demands created by regulatory requirements. This ever-increasing burden poorly impacts the patients’ experience and contributes to the rise in clinicians leaving the medical profession altogether.

With these challenges in mind, health systems, medical experts, and policy makers are looking for solutions that lessen clinician burnout by streamlining required electronic documentation and improving patient satisfaction. In late 2023, the Novant Health Center Public Policy Solutions (the Center) offered one such change that focuses on current billing and documentation regulations for chronic condition management and annual preventive visits.

The Affordable Care Act requires that insurance plans cover annual preventive visits - often referred to as annual check-ups, annual visits, or well visits - at no costs to the patient. However, if the patient wants to discuss a chronic condition such as diabetes, hypertension, or heart failure during the appointment, current policy and insurance coverage requirements necessitate this conversation be documented as a separate visit, which triggers a subsequent bill.

This is unfortunately a common challenge. At Novant Health, more than 60% of Medicare patients and nearly a quarter of commercially insured patients incur additional costs during annual preventive visits due to government and insurance policies and billing requirements.

However, clinician leaders at the Center see a light at the end of a click-filled tunnel. Policy makers can reduce documentation burden, improve patient satisfaction, and promote appropriate, high-quality care delivery by expanding the definition of annual preventive visits to include chronic condition management. The change would mean a single, more comprehensive visit that aligns with what people-focused care should be: fewer clicks and regulations between patients and clinicians.

To learn more about The Center’s latest initiatives or join efforts to modernize annual preventive care, visit www.novanthealth.org/policysolutions or email publicpolicysolutions@novanthealth.org.