American Medical Group Association outlines key policy changes to make healthcare delivery more efficient

The organization also wants federal regulators to eliminate what it views as outdated administrative requirements, including excessive documentation and physician sign-offs for routine services.

“How many signatures do you need? How many face-to-face requirements do you need to order something like diabetic shoes?” Drevna said. “Those little things are relics from a bygone era.”

AMGA argues many Medicare rules were written decades ago for a healthcare system that no longer exists. Drevna pointed to the long-standing Medicare requirement that patients spend at least three days as hospital inpatients before qualifying for transfer to a skilled nursing facility (SNF).

“If the clinical team thinks this patient is ready to leave the hospital and go to a skilled nursing facility, let’s not make them linger in healthcare purgatory for three days,” he said.

Stability in federal health policy

The group is also pushing for permanent extension of telehealth flexibilities that were expanded during the COVID-19 pandemic. Drevna said healthcare systems continue to face uncertainty because Congress repeatedly extends telehealth provisions through temporary continuing resolutions rather than establishing permanent policy.

“Every time Congress does a continuing resolution, it is going to expire this year and it makes it very difficult to plan,” he said.

AMGA additionally raised concerns about instability in alternative payment models administered by the Centers for Medicare and Medicaid Services (CMS). According to Drevna, providers sometimes commit to payment models only to see program rules or performance standards change before they have enough time to adapt.

“Let’s make sure that when a provider signs up for one of these things, it stays the same for a long enough time so they can actually learn how to do it and potentially do well in it before changing,” he said.

Immediate health information sharing

The organization is also working with the Office of the National Coordinator for Health Information Technology on possible changes to federal information-blocking regulations governing immediate release of patient test results. While immediate electronic release of lab and imaging results was intended to improve patient access to health information, Drevna said AMGA members are increasingly concerned that patients are receiving life-changing diagnoses without physician guidance.

He said members of AMGA have reported patients are sometimes learning they have cancer, experienced miscarriages or have other serious conditions through automated notifications, emails or text messages before speaking with a clinician. AMGA is asking ONC to broaden existing exceptions that allow providers to delay release of results in situations where immediate disclosure could cause harm. Current regulations primarily focus on physical harm risks. The group wants emotional distress or emotional harm added to the definition.

Drevna said the current system of early information release outside of clear context from a clinician on their care team has caused confusion. This has led to some patients making unnecessary emergency room visits as patients search online for answers, or seek immediate clarification after receiving test results they do not understand. Receiving normal test results in emergency room visits has also prompted patients to just walk out and go home, when other tests were pending and their physicians planned to admit them.

“We’re trying to craft a solution that respects the patient’s right to their data and getting it to them as quickly as possible, but in a more compassionate way,” he said.