- Patients will have an active and formal voice in health system transformation including payment and delivery system reform; Systemic efforts to contain costs, assess the value of care and treatment, and generate the best outcomes at a reasonable cost should be patient-centered.
- Patients have the right to dignified, culturally competent quality health care.
- Patients will have limited cost sharing and will have predictable and affordable total out-of-pocket costs, including deductibles, co-pays, co-insurance, premium costs or contributions to premiums across care settings.
- Patients will have easily understood and accessible up to date information about covered services, providers, formularies and out-of-pocket costs in all insurance plans during enrollment periods and throughout the year.
- Patients will have reasonable and timely access to all necessary providers in their network and network providers will be within a reasonable distance.
- Patients will pay in-network rates with payments credited to out-of pocket limits for all services provided at in-network settings.
- Patients will have access to necessary medications, services, devices, and other care without discrimination through unreasonable tiering or excessive cost-sharing.
- Patients will not be subject to cumbersome preauthorization and renewal processes that restrict access to care and therapies — including prescriptions and devices.
- Patients will have easily understood and accessible up to date information and guidance regarding appeals, including timely access to a rapid and fair appeals process.
Partners for Better Care and its members believe that every American should have access to affordable, high-quality, patient-centered coverage. We are working with Congress, the Administration, and other health care stakeholders to ensure health system changes work for all Americans, especially those living with debilitating conditions. Click here to read our Health Care Principles.