Brian Loggins, practice manager, Arthritis Associates, San Antonio, Texas, and a member of the GAC, has gone to Washington, D.C., to advocate on the Hill several times. Being active in state politics is another way to be effective because federal policies often end up mirroring state policies, Mr. Loggins says. The Texas Medical Association, for example, recently helped get legislation introduced in the state to limit prior authorization requirements.
Empowering patients to get involved is another way to help drive positive change. In Tennessee, Dr. Phillips and the ISC are working with rheumatology practices to educate patients about such issues as specialty pharmacy policies that threaten patient access to in-office treatments. Informed patients can contact their employers’ human resources staff and encourage them to opt out of harmful insurance policies.
In St. Louis, Mo., outreach to a local insurance carrier’s representative resulted in the carrier reversing policies that required care at a hospital site, according to Dr. Phillips. The success resulted from informing the carrier’s representative about the advantages of in-office infusions for patients in terms of treatment and cost.
Restricting the availability of medications actually adds to the cost for both patients and physicians, according to Chris Morris, MD, FACR, a rheumatologist with Arthritis Associates, Kingsport, Tenn. ACR members in his state are working to address Blue Cross Blue Shield policies that prevent in-office treatments.
“The problem is there are certain areas, like where I live, where policies result in patients being unable to receive infusions in their physician’s office,” Dr. Morris says. “The patients either have to come off the medications or drive several hours to get the medicines we normally give in our office.”
How You Can Help
There are many ways ACR members can get involved in advocacy efforts, including writing letters to insurance carriers, working with the ACR and its committees, meeting with state legislators and disseminating information about insurance practices and medical needs. The GAC and ACR as a whole are dedicated to advocating for rheumatologists and their patients. In 2019 alone, there were several wins in the efforts related to step therapy, prior authorization and bone density scans, as recently reported by GAC chair Blair Solow, MD.
The ACR needs help fighting for changes in legislation, and the best weapon is a united front. Every rheumatologist and ACR member can advance rheumatology by advocating for rheumatology issues, practices and patients, at both state and federal levels. The ACR Advocacy Tools and Resources page provides information about how to get involved. For insurance-specific issues, the ISC exists to help combat harmful insurance practices. Another option is to invest in RheumPAC, the nonpartisan political action committee established by the ACR to help elect and support pro-rheumatology candidates.
