AADA Health System Reform Principles

(Approved by the AADA Board of Directors, 2009) (Revised and Approved by the AADA Board of Directors, 2020)

The American Academy of Dermatology Association established these principles to guide physician leadership in taking policy positions and advocating for health system reform. At the root of these guiding principles is the need to preserve the patient-physician relationship.

• Americans should have access to affordable, quality dermatologic health care, including medications and treatments, 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 to timely care provided by board-certified dermatologists and to board-certified dermatologist-led teams, and providing choice and flexibility for patients and physicians.

• Health system reform and efforts to curb growth in health care costs must not compromise quality care, limit access to coverage options, or harm the patient-physician relationship.

• Health system reform should eliminate mechanisms, including, but not limited to, the sequester of Medicare funds under the Budget Control Act of 2011, and the targeting of particular codes within the Medicare Physician Fee Schedule, which would undermine patients’ access to care through either across-the-board or specialty-specific changes in Medicare reimbursement or coverage polices.

• Health system reform should ensure physicians and physician specialty organizations should continue to play a leading role in evaluating data and making recommendations regarding the relative value of various physician services.

• 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. Physicians and patients should be able to continue to enter into private contracts for the provision of care without penalty.

• Health system reform should provide a means for those with pre-existing conditions to obtain useful and appropriate and affordable coverage.

• Health system reform should ensure that health care premiums are primarily spent on providing care to patients.