Novant initiative focuses on public health policy Novant forms center with public health policy as focus

Addressing and resolving public-health issues is the goal of the Novant Health Center for Public Policy Solutions that debuted last week.

The system said the center is a clinician-led, patient-focused research initiative "designed to elevate public policies that impact health care."

Among the initial priorities are health-care workforce challenges, health-care accessibility, affordability "and other barriers to high-quality care."

"Government mandates and problematic insurance practices require doctors, advanced practice providers and nurses to spend more time with paperwork than with patients," Novant chief executive Carl Armato said.

"We can't stand idly by when we see problems affecting our frontline caregivers and patients. We are stepping in to drive real-world solutions that improve health care for all."

For more information, email to [email protected].

According to the federal Health Resources and Services Administration, 45.6% of all health workers, both clinical and nonclinical, reported feeling burnout often or very often during 2022.

For those in clinical practice, this marks a nearly 39% increase in the prevalence of burnout since the start of the COVID-19 pandemic.

The federal agency estimates that by 2035, there will be a national shortage of more than 81,000 doctors. For the Carolinas, it predicts nursing shortages of more than 10%.

White paper report

The center released last week its first white paper, titled "Addressing over-regulation can help clinician burnout: actions to protect patients and the clinicians who care for them."

The authors of the white paper cited a 2022 survey by the Novant Office of Well-being and Resiliency that found 39% of responding physicians and advanced practice providers reported experiencing burnout.

About 56% of respondents pointed to documentation burdens as their primary source of frustration.

"While the impact to clinicians is significant, they alone do not experience the negative impacts of over-regulation," according to the authors.

"These same regulatory requirements create hurdles for patients to navigate the healthcare system, causing many to delay needed preventive care and chronic condition management, incur unexpected costs and endure growing access challenges as their long-trusted clinicians leave the profession."

The foremost frustration among clinicians is how much time is consumed in complying with filing patient electronic health records, known by the EHR acronym.

"Efforts to prioritize prevention, chronic care management and care coordination are critical, and current policies are well-intentioned," the authors wrote. "They seek to protect the consumer, improve the overall health of patients and bend the healthcare cost curve."

However, the authors said that "the sheer volume of data clinicians are required to capture has consequential impacts beyond a strong dislike for administrative tasks."

"Primary care physicians spend nearly two hours on EHR tasks per hour of direct patient care," according to the paper.

"Regulations now require clinicians to spend significant time satisfying process-driven quality metrics, adhering to complex and inconsistent documentation requirements and navigating administrative processes that minimally contribute to improved healthcare outcomes."

The authors said that using the term burnout "can trigger frustration" among some clinicians.

"For some, it suggests that the problem resides within the individual, who is in some way deficient rather than acknowledging the full weight of the burden created by regulatory and other external mandates."

In response, Novant said it has removed nearly 1.4 million EHR-generated alerts to which clinicians must respond.

"This change has resulted in saving clinicians across the system nearly 2,000 hours of administrative work every 90 days," according to the authors.

"However, such efforts can only go so far before they, too, run into regulatory and insurer policy barriers."

Recommendations

Among the potential solutions recommended by the authors is "ensuring insurers, regardless of the type, cover chronic condition management and acute health care concern care during annual checkups."

In terms of state and federal solutions, the authors recommend:

* Federal lawmakers ensure commercial payors and Medicare Advantage cover chronic condition management and acute health concern care as part of annual checkups at no cost to the patient.

They also are asked to ensure statute changes create coverage consistency across all commercial payors and Medicare Advantage plans.

* Federal agencies ensure all Medicare and Medicare Advantage reimbursements include chronic condition management and acute health concern care, and appropriately reflect the increased level of care provided during annual checkups.

* State lawmakers ensure commercial payors and Medicaid cover chronic condition management and acute health concern care as part of annual checkups at no cost to the patient.

They also are asked to ensure statute changes create coverage consistency across all commercial payors and Medicaid plans.

* State agencies ensure all Medicaid reimbursements include chronic condition management and acute health concern care and appropriately reflect the increased level of care provided during annual checkups.

"If these solutions are implemented, policymakers can anticipate a significant reduction in clinician burden, a positive impact to patient satisfaction and an increase in patient engagement in preventive care, which is proven to be an essential component of quality, affordable care," according to the paper.

"This overall alignment among health systems, clinicians, patients and lawmakers is a step toward ensuring healthcare's long-term viability and affordability."

[email protected]@rcraverWSJ