The following is a press release from ACR dated September 9, 2024:

The ACR Encourages Patients with Rheumatic Diseases to Implement Self-Management Strategies to Improve Quality of Life

American College of Rheumatology (ACR) experts identified research suggesting that patient self-management is not as prevalent as it should or could be despite the improvements patients experience when implemented. This is due, in part, to many patients lacking awareness and motivation to self-manage and thinking the only way to control their disease is by taking their medication.

Today, the ACR launched its patient education campaign, Self-Management for Patients Living with Rheumatic Conditions for Rheumatic Disease Awareness Month (RDAM). The campaign addresses the current knowledge gap, educates patients about self-management techniques, and encourages them to collaborate actively with their rheumatology healthcare team to manage their rheumatic condition.

The campaign does not delve into self-care practices yet focuses on self-management strategies for managing a patient’s rheumatic condition.

“One thing that is important to note is that self-management is often used interchangeably with self-care, but they are different. Self-management is an individual’s day-to-day management of their chronic conditions over the course of an illness,” says Bhakti Shah, MD, a rheumatologist with Crystal Run Healthcare in Middletown, N.Y., and the campaign’s medical spokesperson. “Self-care consists of those tasks performed by healthy people to prevent illness rather than manage an existing illness.”

The campaign highlights five overarching strategies patients can incorporate in their lives. They are:

• Stress Management –Rheumatic conditions can impact a person’s physical and mental health. Patients can create relaxation practices like meditation, self-reflection, or journaling.
• Medication Adherence –Patients should partner with a clinician to understand their medications, what aspects of their disease they treat, and the importance of continuing these medications.
• Lifestyle Changes –Regular exercise and eating a healthy diet are essential for general well-being and may help improve symptoms.
• Communicate and Collaborate with a Healthcare Team –Patients should maintain open communication with their rheumatology healthcare team, including the rheumatologist, physical therapist, and other specialists.
• Maintain a Support System—Patients should ask family or friends for help when needed, especially during a flare.

“Each patient encounter is an opportunity for rheumatologists (and rheumatology health professionals) to remind patients to incorporate self-management techniques in their lives. During my patient visits, I try to review topics such as medication adherence, physical activity and quality of life and I remind them that we are a team and collaboration will lead to improved outcomes for them,” Dr. Shah continues. “We hope this campaign will empower patients to take a more proactive role in their treatment journey.”

Rheumatic Disease Awareness Month is recognized each September, drawing attention to more than 100 conditions under the umbrella of rheumatic diseases. Rheumatoid arthritis, osteoarthritis, and lupus are some of the most commonly known. Others include Sjögren’s syndrome, gout, scleroderma, and psoriatic arthritis. More than 53.2 million American adults—one in four—have been diagnosed with rheumatic disease.

To view the full self-management toolkit, visit www.RDAM.org.

The following is a press release from ACR dated June 24, 2024:

The American College of Rheumatology (ACR) has submitted to the United States House Committee on Ways and Means Health Subcommittee a response to the recent subcommittee hearing, The Collapse of Private Practice: Examining the Challenges Facing Independent Medicine, highlighting issues facing private practices, including inadequate reimbursement for Medicare physicians, burdensome prior authorization policies, and the growing shortage of physicians in the workforce.

In its letter, ACR notes that rising inflation, cuts to reimbursements to below the cost of treating Medicare patients and growing operating costs threaten the viability of private practices. To address these concerns, ACR advocates for legislation to address two persistent challenges impacting Medicare payment to physicians: inflation and a mandatory budget-neutrality requirement. The Strengthening Medicare for Patients and Providers Act (H.R. 2474) would add a permanent annual inflationary update for Medicare physician payments, while the Provider Reimbursement Stability Act (H.R 6371) would help to curtail the negative impact of budget neutrality requirements by raising the current budget neutrality threshold from $20 million to $53 million and requiring its regular re-evaluation.

Given the administrative burden created by costly prior authorization policies, ACR noted its support for efforts to streamline the process so that healthcare team members can spend less time negotiating with insurance companies and more time taking care of patients.

Finally, the shrinking physician workforce creates significant challenges across the healthcare continuum. Unless policymakers intervene, the problem will continue to worsen as fewer physicians are asked to meet the treatment needs of a growing and aging patient population. To address this issue, ACR recommends policies to increase training opportunities, address burnout and early retirement in the healthcare workforce, mitigate the impact of medical education debt, and expand workforce access for visa-holding physicians.

“Private practices are essential to our communities and should be supported by policy,” the letter concludes. “The ACR looks forward to partnering with the Ways & Means Health subcommittee as legislative solutions are considered.”

ACR’s full response letter is available here.

The following is a press release issued by ACR dated June 3, 2024:

The American College of Rheumatology (ACR) has submitted its response to the Centers for Medicare & Medicaid Services (CMS) request for information (RFI) and feedback from stakeholders on how best to enhance Medicare Advantage (MA) data capabilities and increase public transparency.

“Given more than half of Medicare beneficiaries are now choosing Medicare Advantage plans, we applaud CMS for more closely examining this program and, in particular, its impact on those living with complex chronic and acute conditions—including many rheumatic diseases that require specialized expertise and care,” said Dr. Christina Downey, chair of ACR’s Government Affairs Committee. “More reporting and greater transparency around prior authorization processes, care quality, health equity, MA market competition, and prescription drug plans can inform CMS’ decision to implement policies that improve the system for physicians and the healthcare experience for patients.”

ACR notes in its response letter that, “for too long, prior authorization policies by MA-managed care plans have been burdensome and time-consuming and have delayed care for beneficiaries.” To begin addressing this issue, the ACR requests that CMS make publicly available certain metrics on prior authorization, including requests, denials, response rates, reasons for denials, and frequency of denials categorized by type of service. ACR also joined a similar request letter from the Regulatory Relief Coalition asking CMS to implement policies that remove prior authorization barriers to timely care.

ACR also asks CMS to collect and report metrics that would help to better evaluate care quality and outcomes, including value-based care arrangements and efforts to meet health equity goals. This reporting should evaluate potential care disparities faced by MA beneficiaries of color by looking at the prevalence of certain diseases, enrollment in low-rated plans, access to 5-star plans, care outcomes, and average annual premiums. Additional reporting on the percentage of MA beneficiaries under 65 would help paint a clearer picture of how plan design and features impact various populations.

Additionally, given the growth of MA plans, ACR requests that policies support a truly competitive healthcare market. Concerns about consolidation and its impact on quality-of-care prompted ACR to request CMS evaluate bidding figures from each MA plan on an annual basis juxtaposed to the Herfindahl-Hirschman Index score of the markets in which each MA plan operates. Both pre- and post-merger analyses should look at the changes in average annual premiums by the state of residence, plan type, calendar year, and the number of rheumatologists each MA beneficiary has in-network. Consolidation has driven many independent rheumatologists out of practice and limited beneficiaries’ access to care, particularly in underserved communities challenged with accessing a local rheumatologist.

Finally, ACR asks that CMS look specifically at MA prescription drug plans to evaluate their quarterly listings of medications MA beneficiaries have access to and the percentage of MA beneficiaries who reach their out-of-pocket limits every year. Policies that limit choice or increase the cost burden for patients often lead patients to ration their doses or even abandon treatment altogether; in fact, according to recent research, 70% of new patients opt out of filling their prescriptions due to cost. Instead, ACR strongly supports patients having access to the right treatment and any necessary reference products at the right time.

“As the agency begins to explore changes and improvements to MA, ACR stands by as a resource to help ensure that enrollees with rheumatic diseases have better access to the quality care they deserve,” concluded Dr. Downey.