One of the least recognized, most important (certainly for rheumatologists in the U.S. running their own practice), and hardest working committees at the ACR is the Insurance Subcommittee (ISC). Currently chaired by Sean Fahey, MD, and managed by ACR staff liaison Meredith Strozier, this group of dedicated volunteers monitors the insurance landscape, fields complaints from providers’ offices, investigates problems, coordinates with coalition partners and addresses conflicts between health insurance plan sponsors (payers) and rheumatologists all over the country.
Make the Right Connections
Over the past several years, the ISC has redoubled its efforts to establish and cultivate relationships with leaders from insurance companies. These connections have proved beneficial, leading to an improved understanding of the challenges posed by payers whose policies have a dramatic impact on our day-to-day work—not to mention the lives of our patients.
The ACR’s highly productive relationship with two such individuals deserves special mention. Lewis Sandy, MD, UnitedHealth Group, has served as a valuable liaison between the ISC and UnitedHealthcare (UHC) on a number of issues, including the recent delays of a policy to end reimbursement for consultation codes and expansion of UHC’s lab management program, both of which benefited ACR members and our patients. Tim Bartholow, MD, works for WEA Trust, an independent, not-for-profit health insurance company in the upper Midwest. Fluent in both doctor speak and payer speak, he too has been exceptionally effective at establishing dialogue between payers and rheumatologists, and increasing mutual understanding as we navigate the turbulence of payment reform. On a regular basis, he connects with Wisconsin rheumatologists to discuss ways to better recognize the care rheumatologists provide to patients.
The ACR extends its sincerest gratitude to the volunteers and staff of the ISC for their tireless work on behalf of rheumatologists all over the U.S. They are:
- Sean Fahey, MD—Chair
- Anne Eberhard, MD
- Daniel El-Bogdadi, MD
- Howard Kenney, MD
- Barry Myones, MD
- Kamala Nola, PharmD, MS—ARHP Representative
- Yvonne Sherrer, MD
- Richard Stern, MD
- Catherine Sullivan, MD
- Meredith Strozier—ACR Staff Liaison
The ACR would also like to thank the payer liaisons, including Drs. Bartholow and Sandy, for their thoughtful engagement with the ACR.
Douglas White, MD, chairs the ACR’s Committee on Rheumatologic Care (CORC). A committee with a memorable but uninformative name, CORC was created years ago to enhance the voice of ACR members in practice. One of our most important duties, working alongside the Insurance Subcommittee and the Affiliate Society Council, is to help practicing rheumatologists navigate payment reform.