After three rewarding years serving as chair of the Government Affairs Committee (GAC), it is bittersweet to be writing a final message. This month, we welcome Blair Solow, MD (@BlairSolowMD), as the new GAC chair, and the ACR’s advocacy efforts will continue under her excellent leadership.
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As I was reflecting on what I wanted to say in my final post, I kept thinking about the amazing patients I have met through this role. It is relatively easy for rheumatologists to talk to lawmakers about our experiences as doctors. It is another thing entirely for our patients to share intimate, and sometimes painful, details about their private lives and medical histories with a roomful of strangers, all for the sake of helping others. That takes real courage and fortitude, and I’ve been honored to share the podium with many patient advocates during Congressional briefings, hearings and meetings with lawmakers.
Great day on Capitol Hill with amazing rheumatologists(including my own!), speaking with Maryland lawmakers about issues relating to health care and rheumatic conditions. So excited to participate in the process.#RDAM,#Act4Arthritis,#Simpletasks pic.twitter.com/xR2IMg6tVs
— Laura Torchinsky (@Lwtorchi) September 10, 2019
I’ve also learned a lot about advocacy along this journey. First, every voice matters. From the moment one of us decides to speak up about an issue to the moment our collective efforts culminate in a victory on Capitol Hill, there is no substitute for the power of individual voices and stories. Margaret Mead was right when she said, “Never doubt that a small group of committed citizens can change the world. Indeed, it is the only thing that ever has.”
We live in an era of constant change to healthcare policy, and there are constant threats to the rheumatology profession. Every voice matters!
Thanks Senator @DougJones
for leading #StepTherapy reform! Alabama team
advocates including Drs. Crayne & Schnell also spoke about solving the workforce shortage so kids can see a specialist when they need it!@schnell_amanda @CrayneCB @UABRheum pic.twitter.com/VNE7Oh5Qzs
— Angus Worthing MD (@AngusWorthing) September 10, 2019
Second, I’ve learned that despite the hyper-partisanship in Washington, D.C., it is still possible to find common ground when it comes to protecting our profession and our patients’ access to care and treatments. The solutions we advocate for in the rheumatology community are common sense, bipartisan initiatives that leaders on both sides of the aisle can support. We cannot allow ourselves to become jaded by what sometimes feels like a polarized political environment. Change is not easy, but it is possible.
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.
Although I am stepping down as chair, I am not stepping away from advocacy. I am excited to be joining the ACR’s Board of Directors, and I look forward to working alongside each of you to address these critical issues in the years to come.
— Angus Worthing, MD