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President’s Corner: The Practicing Rheumatologist

Carol A. Langford, MD, MHS  |  Issue: April 2025  |  April 5, 2025

Independent, community-based rheumatologists and rheumatology professionals represent a critical part of the ACR and ARP.

My immense respect for clinicians grew while watching my husband, who joined an independent practice after completing rheumatology fellowship. With admiration, I saw how he and his two dedicated partners cared for patients while simultaneously managing overhead and striving to assure job security for their valuable staff, and doing so within the framework of variable reimbursement rates and authorizations from private insurances and Medicare.

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Since my first observations, the challenges facing clinicians have continued to grow, pulling them in different directions and demanding more of their time and effort. In the midst of the many pressures being placed on clinicians, it is understandable for people to ask, “What is the ACR doing for me?” The College offers many resources and strives to support members who serve patients in a clinical practice environment.

Committee on Rheumatologic Care

The ACR Committee on Rheumatologic Care (CORC) focuses on economic, technical and ethical issues that bear on the practice of rheumatology. CORC initiatives are facilitated not only by the committee and its staff, but also through its subcommittees and partnerships. CORC offers a number of resources directed toward the business of rheumatology. An update of the Business of Rheumatology Manual, available on the ACR website, will be released in the third quarter of 2025. ACR Convergence 2025 will offer Business of Rheumatology sessions, plus a new pre-meeting option, the Practice Innovation Summit, which includes the return of the coding course.

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CORC position statements cover a range of topics reflecting the policy of the ACR on issues impacting patients and providers. In addition to developing new statements when needed, previous statements are reviewed and updated on a regular basis to ensure relevance to current practice.

The Insurance Subcommittee helps clinicians navigate insurance-related issues, including resources to assist with insurance grievances, complaints and denials. Members can access information on filing a state insurance department complaint, and template letters to help protect access to physician-administered therapies and to secure insurance approval for off-label uses frequently seen in rheumatology practices. The ACR website also includes fact sheets providing information on current critical issues, including underwater biosimilars and the G2211 code. Further information about these resources can be found at https://rheumatology.org/insurance-advocacy, which includes phone and email contact information for specific questions members may have about insurance-related concerns.

The Community Practice Council (CPC) was  founded in 2023 with the goal of ensuring the ACR is addressing the needs of, and providing value to, practicing clinicians. The CPC includes rheumatologists in private, solo, or small group practice from around the country who meet monthly to address issues confronting ACR members in small and independent practices. CPC members are happy to answer questions or concerns from colleagues in practice or from fellows considering a career in private practice. The CPC can be contacted by email at [email protected].

CORC maintains active affiliations with other organizations that support the practicing rheumatologist, including the Coalition of State Rheumatology Organizations (CSRO), and the American College of Physicians Council of Subspeciality Societies and Subspecialty Advisory Group on Socioeconomic Affairs.

Advocacy

The first few months of the new administration and 119th Congress have seen significant activity regarding healthcare, with more changes anticipated. The ACR advocacy website offers members up-to-date news on what’s going on in Washington, D.C., and the ACR’s ongoing efforts.

Through its office in Washington, D.C., the ACR participates in Congressional hearings and meetings, allowing our advocacy team to educate lawmakers on the impact of proposed policies on the rheumatology community and our patients. The ACR also advocates in state capitols across the country. ACR advocacy covers a broad range of issues, and those with particular impact on practicing rheumatologists have included ensuring adequate Medicare reimbursement, drug pricing, preserving reimbursement parity for telehealth and reducing clinician busywork that can be a barrier to access through reform directed toward prior authorization and step therapy.

The Affiliate Society Council (ASC) is a vital part of the ACR’s advocacy framework and seeks to enhance collaboration between state societies and the ACR. The ASC brings together rheumatology providers from member states to share lessons learned and to work through legislative and regulatory issues at the state level in generating solutions.

Clinical Tools, Guidelines & Guidance

Busy clinicians need reliable information that reflects the most recent advancements in patient care. With that in mind, the ACR has developed and updates evidence-based guidelines on a range of rheumatic diseases, as well as on topics for which clinical guidance is desired by the rheumatology community. Members also have access to more than 40 medication guides that provide streamlined information on the administration of biologic, anti-resorptive and other pharmacologic agents used to treat patients with rheumatic disease.

RISE Registry

The RISE registry, the first and largest electronic health record (EHR) enabled rheumatology registry in the U.S., collects information obtained during routine clinical care. RISE assists clinicians in meeting government-mandated reporting requirements and improving reimbursement. Participation in RISE is available to ACR/ARP members and their practices as a free member benefit. It can be used to complete reporting requirements for the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS) and MIPS Value Pathway (MVP).

COMMITTEE MEMBERSHIP

Applications are accepted April 1–June 1. Volunteer today: https://rheumatology.org/volunteer-opportunities.

Practice & the Rheumatology Professional

The ARP offers novel educational programs directed toward rheumatology professionals, which are valuable not only to the professionals themselves, but also to practicing rheumatologists who are bringing new members into their teams. These include the Fundamentals of Rheumatology Course, which comprises 10 online learning activities that provide foundational knowledge for professionals new to rheumatology, as well as the Advanced Rheumatology Course, a comprehensive, 19-module educational series geared toward members of the rheumatology interprofessional team seeking a deeper dive into the subject.

Patient Education

The ACR provides a wide range of patient-directed materials to assist clinicians in their goal of empowering patients through knowledge about their disease and treatment. These include information on some of the most common rheumatic diseases and conditions, as well as medication fact sheets, most of which are available in both English and Spanish.

Clinicians play a vital role not only for their patients, but also for the ACR and ARP. Community-based rheumatologists serve in many different volunteer capacities throughout the College, including within our committees, on the Board of Directors, and on the Executive Committee. The voice of the clinician is essential to every aspect of the ACR and ARP, and I openly invite our members in practice to join our volunteer team.


Carol A. Langford, MD, MHS

Carol A. Langford, MD, MHS, is the director of the Center for Vasculitis Care and Research in the Department of Rheumatic and Immunologic Diseases at Cleveland Clinic, where she is professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, and holds the Harold C. Schott endowed chair in rheumatic and immunologic diseases.

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