A New Administration Brings Updated ACR Policy Positions

The ACR continues to broaden its advocacy efforts on issues critical to rheumatology, as described in updates to its 2017 health policy statements. Along with continuing to advocate for access to care and treatments, enhancements to rheumatology research and training the next generation of rheumatologists, the 2017 health policy statements address a number of new policies deemed critical for the practice of rheumatology in the ever-evolving healthcare landscape.

According to Angus Worthing, MD, chair of the ACR’s Government Affairs Committee (GAC), key advocacy areas in 2017 include: 1) MACRA implementation issues; 2) the debate around healthcare reform in the 115th Congress; and 3) the approval and use of biosimilars.

MACRA Implementation
Kwas Huston, MD, a member of the GAC, highlighted the following specific positions supported by the ACR for MACRA implementation:

• The need for simplicity and transparency to ensure that rheumatologists understand and can navigate both MACRA pathways (i.e., Merit-Based Incentive Payment System [MIPS] and Alternative Payment Models [APMs]);
• The need to reduce administrative burdens associated with MACRA;
• The need to not hold rheumatologists accountable for costs beyond their control (i.e., the price of biologics); and
• The need to ensure participation in qualified clinical data registries, such as the Rheumatology Informatics System for Effectiveness (RISE) Registry, will count toward MIPS requirements.

Ensuring patient access to important treatment is a key area of advocacy, according to Dr. Worthing. The ACR “cautions Medicare that including the cost of expensive medicines in any reimbursement or penalty calculation may reduce patient access to important treatments,” he says.

Healthcare Reform, Biosimilars & More

Dr. Worthing says the ACR continues to support:

• Repeal of the Independent Payment Advisory Board (IPAB) provision of the Patient Protection & Affordable Care Act;
• Minimization of the administrative burden through universal prior authorization in the case of multistate insurance plans;
• Maintaining the Food and Drug Administration’s (FDA’s) authority to approve safe, effective biosimilars that can encourage market-based relief from the high costs of biologic arthritis drugs;
• Adequate reimbursement for rheumatology services, as well as loan payments (particularly considering the impending workforce shortage);
• Inclusion of safe, affordable medications in formularies;
• Allowing multiple doctors to use chronic care management codes;
• FDA funding and hiring reforms, specifically for the evaluation of biosimilars;
• The allocation of $20 million from the Department of Defense for dedicated arthritis research; and
• The inclusion of valid, methodologically sound and meaningful comparative effectiveness data in FDA drug labels.

Along with focusing advocacy in 2017 on these updated policies, Dr. Worthing says the ACR remains committed to advocating for robust rheumatology research, training of the future rheumatology workforce and innovative methods to curb the high price of biologics.