A little more than three years ago, rheumatologist Michael Brooks, MD, FACP, FACR, Cedar Rapids, Iowa, turned years of discussion into something tangible: He and his colleagues got the paperwork and financial requirements in order and officially started the Rheumatology Association of Iowa.
“We had been trying to get something going statewide in terms of an advocacy group for many years, but for one reason or another it did not take shape,” Dr. Brooks says.
Today, 70–75% of the state’s clinical rheumatologists are members of the association, which has a board and has successfully organized three meetings geared toward practicing rheumatologists.
A Need-Driven Success
“One of the successes of our organization so far is that we’ve been able to get membership from nearly all clinical rheumatology practices in a wide spectrum from across the state,” says Dr. Brooks, president of the association. “I think it’s been successful because there’s a great need for it.”
For example, the cited rates of rheumatoid arthritis are significantly lower in Iowa than in surrounding states, Dr. Brooks says. “It gives us the indication that [many] patients are being missed who have rheumatoid arthritis, and they don’t get diagnosed because they’re not seeing specialists.”
To counter this, the association plans to reach out to primary care physicians to educate them on RA symptoms and let them know there are rheumatologists available to help.
Staying True to Its Intent
Additionally, the association has hewed to its original intent: advocacy.
At the association’s 2017 annual meeting, representatives from Wellmark Blue Cross/Blue Shield Iowa delivered the keynote address, opening discussions about medical care and improving communication between rheumatologists and the health insurer, which Dr. Brooks says covers 60–80% of the non-Medicare market. He now sits on the insurer’s pharmacy committee, where he advocates for Hawkeye State rheumatologists and their patients.
“We are able to talk to them [Wellmark] about why we need certain medications and about expediting the approval process for our patients, and we help make decisions about their formulary and tiering for everybody on their insurance,” Dr. Brooks says.
Additionally, Dr. Brooks and several colleagues will soon participate in Doctor’s Day in Des Moines, where he, colleagues and patients will meet with state legislators to lobby on behalf of rheumatologic care. This is particularly pertinent, Dr. Brooks says, because the Iowa legislature is considering step therapy and biosimilar bills.
“I was able to discuss legislation with my senator and representative who both supported our step therapy legislation,” Dr. Brooks says. “It passed both houses unanimously and is awaiting the governor’s signature.”
ACR Participation
This year, the association’s third annual meeting took place at the end of February and ACR Government Affairs Committee Chair Angus Worthing, FACR, FACP, participated in its legislative and advocacy issues panel, intended to help Iowa providers stay current on national issues, adapt efforts to their state and discuss advocacy around the biosimilar and step therapy bills.
“Most of us have not been trained in terms of advocacy, and I don’t think anybody up until now has had much significant experience with it,” says Dr. Brooks. “To bring in that expertise, in terms of what other people have done and what’s successful and what to expect, is vital to our success.”
Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wis.