New principles guide Academy in policy positions and advocacy

The Academy’s Board of Directors recently approved updated principles to help guide the American Academy of Dermatology Association (AADA) and its physician leadership in taking policy positions and advocating for health system reform. Member to Member discussed the revised principles with Bruce Brod, MD, chair of the Academy’s Congressional Policy Committee. Dr. Brod discussed the revised principles prior to the House of Representatives’ May 4th passage of the American Health Care Act, which would repeal and replace much of the Affordable Care Act (ACA), including the tax on indoor tanning services. This legislation now heads to the Senate for consideration.

Member to Member: Why did the AADA create the principles?

brod-bruce.jpgDr. Brod: They were created so that we have a stand-alone statement that will set a foundation for the AADA as health system reform continues to evolve and change. With ongoing attention on the ACA and health reform in Congress, the decision was made to update the principles, which are really a repository of guidelines that are supported by our position statements.

Health system reform is such an evolving and changing process that we felt a set of principles is important as we advocate on behalf of our patients and our specialty.

M2M: These principles were first established in 2009. How have they been revised to meet the changing health care landscape?

Dr. Brod: We maintained core principles from the original guidelines, such as medical liability relief, but we revised the principles to fit with the current health system reform landscape. We made some updates because some of the original principles didn’t pertain to the current climate.

In general, the principles address preserving a system that maintains patient access to dermatologic care that’s reasonable and affordable. It also underscores the importance of a patient’s ability to choose and the sanctity of the patient-physician relationship.

In the new version, we specifically delineate the AADA’s support for the repeal of the Independent Payment Advisory Board, also known as IPAB, which is something that wasn’t a pressing issue in 2009. The IPAB, as we now know it, did not even exist until it was created under the Affordable Care Act, but IPAB, if triggered and required to act, has the potential to disrupt access to needed health care for our patients.

Also, with the movement toward more consumer-driven health care, we wanted the principles to address the necessity for affordable medication and treatments for all patients.

M2M: The AADA has made substantial progress in regulatory and legislative areas in recent years. Will these principles rollback this progress?

Dr. Brod: The principles will in no way dismantle progress we’ve made in regulatory and legislative areas in the past several years. We specifically address the need to eliminate burdensome regulatory and administrative policies that harm patient care, but this is not a blunt axe approach. It’s not our principle to eliminate all regulations. There are policies that we have worked very hard to establish and we’d like to see those continue to advance.

There are regulations that are burdensome and others that are helpful and actually improve patient access to care. We want to make sure that the work we’ve done in those areas continues to preserve the ability to maintain such things as network adequacy, data sharing, and other regulatory issues where the AADA has taken a lead role in successfully advocating for policy changes.

AADA Health System Reform Principles

  • Americans should have access to affordable, quality dermatologic health care, and individuals should be free to choose their own physicians and the health insurance that best meets their needs.
  • Health system reform must preserve diverse coverage options and ensure adequate and transparent networks of specialists and subspecialists offered by a multitude of insurers – maintaining access, choice and flexibility for patients and physicians.
  • Health system reform and efforts to curb growth in health care costs must not compromise quality care or harm the patient-physician relationship.
  • Health system reform should include repeal of the Independent Payment Advisory Board (IPAB), which, if required to act, would be empowered to make significant decisions about Medicare policy and payment decisions without a mechanism for public accountability or congressional oversight.
  • Health system reform should eliminate a multitude of regulatory and administrative burdens that increase costs and do not improve patient care.
  • Health system reform should include medical liability relief.
  • New payment models, quality measurement, data collection, including, but not limited to clinical data registries, and reporting must be driven by physicians and physician specialty organizations. The purpose of these efforts must prioritize quality improvement over cost reduction, and such programs should be voluntary.
  • Any new insurance coverage option must be voluntary for physicians, pay physicians fairly, and compete on a level playing field to prevent crowd-out of existing plans.
  • Health system reform should provide a means for those with pre-existing conditions to obtain useful and affordable coverage.
  • Health system reform should ensure that health care premiums are primarily spent on providing care to patients.