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    Derms urged to be step ahead of evolving regulatory environment

    Specialists must remain informed, active regarding impact of healthcare reform measures


    Miami Beach, Fla. — For dermatologists, key concerns created by the Patient Protection and Affordable Care Act (ACA) and other elements of healthcare reform include patient access and provider payments, says an American Academy of Dermatology (AAD) official. Fortunately, he adds, the varied and largely office-based nature of dermatology could provide unique advantages in the evolving regulatory environment.

    The AAD is monitoring the impact of several ACA mandates including health insurance exchanges and accountable care organizations (ACOs) on patient care and the specialty of dermatology, says AAD President Brett Coldiron, M.D., who is in private practice in Cincinnati.

    Regarding insurance exchanges, he says the academy is primarily concerned with ensuring that these arrangements “do not limit access for patients due to insufficient networks and high deductibles, which many people cannot afford.” Although the AAD has taken no official position on these entities, Dr. Coldiron says, “The academy is keenly interested in whether or not these new plans provide an adequate network of providers and do not hinder access to quality dermatologic care.”

    Addressing ACOs

    The AAD is also actively advocating for the broadening of Medicare Advantage networks, which have been cut, to the detriment of patients’ access, Dr. Coldiron says.

    “AAD Executive Director and CEO Elaine Weiss, J.D., and I met with White House and key congressional officials in February to discuss the issue and relay the specialty’s concerns that narrowed networks will have devastating effects on patient access to quality care. The AAD Association (AADA) will continue to work with policymakers on this issue,” he says.

    Regarding ACOs, Dr. Coldiron says that while several dermatologists are joining these organizations, “Right now ACOs are often hospital-based. The academy is particularly interested in the effect of these arrangements on solo practitioners like dermatologists, and the effects on access to specialty services — which remain unclear and varied at this point.”

    It’s premature to predict whether the ACO payment system is here to stay, he says. However, “Some theories suggest that payment systems based on quality care, patient safety and cost effectiveness could replace fee-for-service systems.”


    John Jesitus
    John Jesitus is a medical writer based in Westminster, CO.


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