Our Insurance Subcommittee (ISC) fields and responds to questions from individual members; if you have any, please reach out to us via email or phone. Below are some pressing issues this group is working on now:
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- Ensuring that payers who are implementing site-of-service policies designed to move infusions away from higher cost hospital settings will not harm patients’ care; and
- Addressing downcoding by some Medicare carriers, a tactic that could reduce patient access to biologic drugs by decreasing Medicare reimbursement for administration of these important treatments.
We will also write or call insurance carriers to address pressing issues on your behalf. We review draft policies by all carriers to provide our feedback—so rheumatologists have a voice when it comes to how our patients’ treatments are covered and how your practice is reimbursed.
The ACR’s mission is to Advance Rheumatology!, & we can do that only if we ensure that every member can do their work effectively.
RISE Is on the Rise
The ACR’s qualified clinical data registry, Rheumatology Informatics System for Effectiveness (RISE), now includes data from about 900,000 rheumatology patients and is growing each week. RISE can help practicing rheumatologists track the quality of care they deliver to their patients and identify areas where their practice can improve. They can also compare the quality of care in their practice to that provided by peers, regionally or nationally.
RISE is a qualified registry and using it can help members score points under MACRA if their practice reports quality measures on the MIPS track, which most will do in the early years of the new reimbursement program. Did you know that using RISE automatically gets you points to improve your overall quality score and avoid a negative payment adjustment in this first year of MACRA? Once RISE is hooked up to your practice’s electronic health record, it can passively extract quality data and report it to the CMS so your staff does not have to do any dual data entry work to report quality measures.
Signing up for RISE is free for all ACR and ARHP members. The ACR will provide technology support to connect you to RISE and tailor it to the way your practice collects and analyzes data. This way, you will not have to change your workflow or style to collect and report quality data.
We know that not every rheumatology practice can successfully set up RISE at this time due to connectivity challenges with EHR systems with cloud-based data storage or networks with tough security firewalls. We are committed to solving these problems so more rheumatologists can use RISE—both for reporting quality measures under MACRA and to improve the quality of care they deliver to their patients.
Why leave the office to test your skills and get up to date on the latest rheumatology knowledge? Try the ACR’s excellent self-assessment CARE (Continuing Assessment, Review and Evaluation) programs, including the new 2016 module, right from your office or home. CARE is an online self-assessment tool designed to assess your rheumatology medical knowledge base. The questions have gone through an extensive review and validation process so you can be sure they are relevant to your clinical practice.