Rheumatologists significantly improve quality of life and lower healthcare costs for patients with rheumatic disease. Having enough rheumatologists and rheumatology professionals can optimize patient outcomes and help fully realize the economic benefits of rheumatologic care within health systems.
These two positions on rheumatology may not be surprising to those working within the specialty, but they may be valuable for others to appreciate.
Ultimately, it could make a difference on reimbursement and resources used to attract more rheumatologists to a declining workforce within the specialty.
To help spread the word about rheumatology’s value, the ACR now has released a position statement as well as a white paper on the clinical and economical value of rheumatology.1,2
The white paper, The Clinical & Economic Value of Rheumatology: An Analysis of Market Supply and Utilization in the United States, was the product of a taskforce of ACR members who worked with ECG Management Consultants to analyze the value of care given by rheumatologists.1 ECG has worked with other specialties, such as primary care, to help quantify their economic value.
The Value of Rheumatology Working Group helped to guide the purpose and content for the white paper.
The white paper is full of impressive facts and insights about the specialty (see sidebar), including some that may surprise even rheumatologists, according to those who helped to create the report.
“A rheumatologist will appreciate that the national estimated billing, in the form of professional and ancillary direct and downstream billing, is $3.5 million per rheumatologist per year,” says Daniel F. Battafarano, DO, MACP, MACR, chair of the ACR’s Workforce Solutions Committee and adjunct professor of medicine, UT Health-San Antonio, Texas.
Additionally, a single rheumatologist impacts the local and national economy downstream through job creation, wages and benefits, and state and tax revenue, Dr. Battafarano says, adding that the size of the impact varies by individual state.
The benefit of rheumatologic care to patients, their workplaces and society is another theme of the white paper that may surprise some, says Marcus Snow, MD, chair of the ACR’s Committee on Rheumatologic Care (CORC) and an associate professor in the Division of Rheumatology, University of Nebraska Medical Center, Omaha. “Our work keeps people working and active, which can have downstream effects for years,” he says.
Facts and Stats: The Clinical & Economic Value of Rheumatology
- Aggressive rheumatoid arthritis treatments reduce cardiovascular events, decrease healthcare costs and improve overall quality of life significantly.
- Patients with gout who are managed by a rheumatologist have fewer emergency room visits, leading to considerable cost savings.
- Rheumatologists were able to assist in caring for critically ill patients with COVID-19 because of their experience treating systemic inflammation and prescribing immune-modulating therapy.
- Markets with a high supply of rheumatologists had lower average costs per patient for ER visits and hospitalizations compared with those that had a low supply.
- The preventive value of rheumatology care was estimated at $2,762 per patient per year.
Planting the Seeds
The need for the white paper and ACR position statement came about as many large employers chose not to update their Relative Value Unit (RVU) reimbursement in 2020, even though the Centers for Medicare & Medicaid Services (CMS) changed billing rates to boost those in cognitive specialties, including rheumatology, in response to advocacy by the ACR and its partners in other specialties, says Dr. Snow.