2017 Health Policy Principles
The Alliance of Specialty Medicine advocates for sound federal health care policy that fosters
patient access to the highest quality specialty care and improves timely access to high-quality
medical care for all Americans. As patient and physician advocates, the Alliance welcomes the
opportunity to proactively participate in the formation of health and Medicare policy and looks
forward to working with this Administration and Congress. Outlined below are key policy issues
of importance to ensure access to specialty care and to promote transparency, oversight and
accountability in the healthcare system.
Access to Specialty Care
Health care plans in the private market and Medicare should provide timely access to specialty
care. Key to this theme is addressing narrow networks, providing comprehensive medical liability
reform, allowing private contracting, maintaining a viable fee-for-service option, and addressing
workforce shortages.
Ensure Network Adequacy
Patients face access to care barriers due to narrow health plan networks. Many times,
unknown to patients, entire specialties are excluded from health plans or the number and
mix of specialists and subspecialists are not adequate to meet the needs of the insured
population. Networks should be sufficiently robust to ensure that an appropriate number of
specialists and subspecialists per enrollee are available. Additionally, network directories
should be updated in real-time and provide patients with clear, concise, and accurate
information. Finally, decisions to remove a physician from the network without cause should
not be made in the middle of a contract year. Congress and the Administration should ensure
appropriate oversight to hold insurers accountable to ensure patients have timely access
to the right care, in the right setting, by the most appropriate health care provider.
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