American College of Rheumatology Releases 2022 Rheumatic Disease Report Card

The American College of Rheumatology (ACR) recently published its 2022 Rheumatic Disease Report Card, which examines how easily a person with a rheumatic disease can live well in the United States. The goal of the report was to inform and motivate policymakers and the public to address healthcare access, affordability, and lifestyle factors that impact quality of life for these patients. empower

Rebecca Shepherd, MD, MBA, FACR, FACP, who Chairs the Insurance Subcommittee of the Rheumatologic Care Committee, discusses the Rheumatic Disease Report Card in depth, including the criteria used to assess each state, what can be done to improve scores, and the next steps for her team. Shepherd is Director of Osteoporosis Care at Lancaster General Health and Chief of the Division of Rheumatology at Lancaster General Hospital.

Rebecca Shepherd, MD, MBA, FACR, FACP

Rheumatology Network: What was the impetus for your team to create a rheumatic disease report card?

Rebecca Shepherd, MD, MBA, FACR, FACP: We wanted to create a public awareness campaign that coincided with September being Arthritis Awareness Month and we've had some critical changes that are needed in certain states. This was a way to highlight some of the areas where we need some movement.

RN: What was the criteria that you use to judge individual states?

RS: That is a good question. We had 3 basic areas that we focused on: access, affordability, and activity levels. And within each of those 3 areas, we had certain identifiable metrics for which we would be given certain point levels.

RN: Why do most states fail to deliver quality care to this patient population?

RS: Well, that's a complex question. And so, I'll focus on a couple different things. I think that rheumatoid care has not garnered as much attention as certain other big medical issues, such as coronary disease and cancer, but it has an extreme impact on certain populations. And we think that there is not good access to rheumatologists. We think that there are a lot of uninsured residents. We think that there are a lot of laws that could be created to help improve restricted access to care. And we would really like to focus on improving quality of life and reducing disability and pain and suffering.

RN: What impact does this have on patient health?

RS: There is a huge impact if patients can't get in to be seen by a rheumatologist or don't have access to care because of restrictive financial policies by insurance companies. They basically have untreated disease or undertreated disease, and that creates a tremendous amount of disability, pain, and can even lead to increased mortality rates.

RN: What can be done to improve these scores?

RS: Each state is given a score, not to make it feel bad about itself, but to highlight areas where lawmakers, providers, and policymakers can really focus. The big area that we think lawmakers can really help is to create some definition around insurance companies’ policies. A good example would be lawmakers passing legislation to restrict specialty tiers and helping to create some transparency through pharmacy benefit managers. Or, for example, passing legislation against some other things like copay accumulator programs. These are things that make it much more expensive for patients to access the medications that they need.

RN: What are the next steps for your team?

RS: We work hand in hand with different legislative bodies and we're happy to help educate state legislators on areas where they can help improve quality of life for patients. But I think in part this is also to bring attention to patients themselves, so they understand where they stand in their state and what they can do to help move things forward, feel empowered, and help educate themselves on what they need to their legislators to do for them.

RN: Is there anything else that you would like to add?

RS: One of the greatest things about this area of interest is that states can move up and can really improve. There’s a lot of room for states to make a difference. Wyoming, for example, has an opportunity to improve its access and affordability by establishing state legislation. Kentucky is looking at potentially passing a gold card legislation and Texas has done so already. Florida has a huge senior population and they've got a lot of room for implementing things like copay accumulator limitations and specialty tiers. So, we're looking forward to working on this on a state-to-state level and helping to highlight some of the areas that the legislators can make a difference for their subjects.