Finally, there is never a dull moment in the world of advocacy. It is exciting, exhilarating and rewarding work that introduces you to fun, interesting and energizing people. Getting the chance to travel and meet dedicated rheumatologists and patient advocates across the country (including Alaska) has been a highlight of my time as chair. I am grateful for and proud of the successes achieved by our team of staff, volunteers and grassroots advocates during my tenure. Here are just a few highlights:
- Successful adoption of a 365-day lookback period under Medicare Part B that ensures patients currently receiving in-office medications through Medicare won’t have to go through step therapy;
- Growing our Simple Tasks advocate network to include patients from all 50 states who are ready and willing to reach out to their members of Congress and local media;
- Media coverage in The New York Times about the undervaluing of complex rheumatology services in Medicare. The story, along with our other advocacy efforts, helped convince the administration to change a proposed plan to cut payments for E/M services. Instead, it will implement payment boosts for E/M and other coding changes that will result in an estimated 15% payment increase on average for rheumatologists beginning in 2021, helping protect patient access to high-quality rheumatology care and services. (Plus, I got to show my mom that I made the paper!); and
- The technical correction in legislation that prevents Medicare’s Merit-Based Incentive Payment System (MIPS) penalties from applying to doctors’ infusion practices so we can continue to provide medications in the clinic or infusion center without threat of penalty for prescribing these critically important drugs to our patients.
There are many more successes, and these are just a few. Of course, challenges remain. We need to improve patient access to breakthrough drugs and reduce specialty drug costs. We need policies that promote the use of safe and effective biosimilars and that prevent pharmacy benefit managers from receiving kickbacks and using step therapy to drive up drug costs and prevent and delay patient treatments. We must protect access to innovative and inexpensive diagnostic technology such as DXA scans and make sure patients can see a rheumatologist when they need one.
I am looking forward to seeing Dr. Solow, our incoming chair, guide the ACR’s advocacy efforts to new heights. Many of you know that Dr. Solow is a rheumatologist, researcher and educator at UT Southwestern Medical Center with a long advocacy résumé, including helping build Advocacy 101, the first of its kind advocacy bootcamp for rheumatology fellows in training for the ACR.
