Repealing IPAB Key to Preserving Patient Access to Health Care

As a dermatologic surgeon and president of the American Society for Dermatologic Surgery Association, I value our elderly citizens and proudly treat Medicare patients in my own practice. But the Medicare program and seniors’ access to quality health care faces an imminent threat unless Congress acts rapidly to address it.

That threat is the government-created Independent Payment Advisory Board, a never-tested entity charged with making significant cuts to the Medicare program. The panel is triggered when spending reaches an arbitrary level and it is expected that IPAB could be called into action soon, compelling it to make cuts that threaten access and care to seniors who make up the Medicare patient population. Fewer than half of IPAB appointees are health care providers and, oddly, none are permitted to be practicing physicians. Control over the health care of millions of seniors and disabled Americans will lack the input of those who know and understand how to treat patients best.  

ASDSA has been steadfast in alerting Congress of these possibly dire implications due to the potential actions of this unelected, unaccountable panel. Access to quality skin cancer treatments is at risk, along with other pressing health care needs. Luckily, there is bipartisan agreement in Congress that IPAB is an ill-conceived idea that needs to be stopped. The Medicare program already shortchanges seniors by reimbursing physicians, including dermatologic surgeons, less than what private insurers feel is fair for quality patient care. IPAB-generated cuts would widen this gap and force more physicians to deny affordable care to Medicare patients, and create access issues that limit their ability to be treated with new, effective treatments. This includes therapies to treat the epidemic of skin cancer and other serious skin diseases. These barriers to care are not acceptable for our elderly patients, or anyone.

Meaningful IPAB repeal legislation has been introduced in Congress, but Republicans and Democrats must work together to pass these measures before the wheels of IPAB are set into motion and Medicare patients lose out on quality care.

Preserving a strong, accessible Medicare program is echoed by over 650 organizations across the country that represent patients, doctors, hospitals, employers, veterans and others who realize the urgency of this issue. There is widespread agreement that Medicare can and should be improved. Linking Medicare patients who fight chronic and deadly diseases daily (like skin cancer) to evidence-based treatments is key in transitioning Medicare away from the outdated fee-for-service model to value-based care that emphasizes preventive health, improved outcomes and greater cost-efficiency. These efforts should be allowed to continue without IPAB thwarting progress and hurting our most vulnerable patients.

Acting quickly is imperative. Health care experts, including Medicare’s own trustees, predict IPAB will be triggered into action soon. There is no compelling justification to maintain a mechanism that will simply cut resources from a health care program serving over 55 million Americans and, in doing so, undermine quality, access, value and sustainability. Let Congress know they must act decisively and immediately to keep America’s Medicare promise to the senior citizens of our great country.


Thomas E. Rohrer is president of the American Society for Dermatologic Surgery Association.

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