Workforce initiatives continue to be at the forefront of the ACR’s advocacy efforts. Nationally, pediatric rheumatology fellowship programs fill around 50% of their slots. Meanwhile, adult rheumatology fellowship programs must turn away applicants. The cap on Medicare support for graduate medical education has been in place for more than two decades via the Balanced Budget Act of 1997.
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Explore This IssueJune 2021
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The Resident Physician Shortage Reduction Act (S. 834/ H.R. 2256) was re-introduced in the House and Senate. It adds 14,000 Medicare-funded graduate medical education slots over seven years.
The Pediatric Subspecialty Loan Repayment Program (PSLRP) would address the pediatric workforce shortage by providing funds for loan forgiveness when certain metrics are met. Although the PSLRP was authorized by the CARES Act in 2020, it has not yet been funded. The ACR is advocating for an initial $50 million appropriation.
At the state level, we are also making progress on our workforce initiatives. The ACR’s model, cognitive care loan forgiveness bill was re-introduced in the Georgia House of Representatives this year. In Washington, pediatric rheumatology loan forgiveness was amended into the state budget. This would be the first state to allow pediatric rheumatologists to apply to state loan forgiveness programs. We are working with our partners to ensure this provision stays in the budget that is sent to the governor.
How you can help: Visit the Legislative Action Center to find a pre-populated letter to legislators you can send showing your support for these workforce actions.
The U.S. Department of Defense allocates research funding to certain diseases, as well as a general fund. To date, researchers seeking grants related to rheumatic disease have had to apply via the general fund. The ACR is working toward having a line item dedicated to arthritis research, given that arthritis is the second-leading cause of medical discharge from the military. This slow-moving effort has gained serious traction, and I am hopeful we may be successful in this Congress.
How you can help: Visit the Legislative Action Center to find a pre-populated letter to legislators you can send showing your support for this funding.
Although the PSLRP was authorized by the CARES Act in 2020, it has not yet been funded. The ACR is advocating for an initial $50 million appropriation.
Telehealth—Parity & Access
Prior to 2020, telehealth was practiced only by a few providers. Following the extreme drop in patient visits during the public health emergency (PHE), providers quickly learned and implemented telehealth practices to treat patients virtually. The CMS, followed by commercial payers, increased the reimbursement for telehealth to match in-person visits for audio-visual and, later, audio-only visits during the PHE. Several active pieces of legislation moving through Congress and in various states would expand access to telehealth beyond the PHE.
How you can help: Watch for a call to action to send letters to Congress, the administration and state legislators to continue to expand telehealth flexibility and ensure appropriate reimbursement.