Physician Practice Advocacy

Physician practice advocacy is at the heart of PAI’s mission.  Today’s payment/regulatory environment and rapidly evolving health care marketplace presents a host of challenges for physicians, contributing to a high rate of “burnout.”  Physicians across the country have sold their practices to hospitals or health systems at an unprecedented pace.  Physicians who remain in solo or small group practices are struggling to keep their practices afloat financially.  All physicians - employed and independent - strive to deliver the highest possible quality for their patients, even as insurance coverage erodes.   

The challenges facing physicians include: 

• Financial pressures resulting from reimbursement cuts; 
• Outdated regulatory and payment policies that create an unlevel playing field for physicians to lead innovative approaches to care delivery and financing;
• Value-based payment programs that require substantial reporting and add a massive regulatory burden without leading to higher quality outcomes for patients;
• Ever-changing coding and payment policies from government and commercial payers;
• Eroding health plan coverage, including narrow networks, limited service policies and high deductible policies, which can negatively impact physicians’ ability to treat patients in accordance with their best medical judgment;
• Expensive, time-consuming administrative and regulatory hassles, including prior authorization requirements, electronic medical record (EMR) maintenance and other regulatory compliance policies that make it challenging to sustain a medical practice today; 
• Barriers to accessing necessary data that impacts physicians’ clinical decision making and ability to participate successfully in value-based programs; and
• Audit processes by payers, including Medicare, that lack transparency and create significant hurdles for physicians who seek to appeal an auditors’ findings. 

PAI Advocacy to Sustain Physician Practices

PAI’s advocacy to address these myriad issues falls primarily into two buckets:  

Regulatory Relief / Administration Simplification

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Promoting Interoperability of Health Data

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