As a community rheumatologist in Paducah, Ky., Chris Phillips, MD, understands firsthand the practice challenges that rheumatologists face. He’s advocated for the voice of rheumatology on these very challenges for nearly a decade through various volunteer roles within the ACR.
Dr. Phillips
Dr. Phillips recently stepped into his latest volunteer role for the College as chair of the Committee on Rheumatologic Care (CORC). CORC is tasked with supporting the economic, technical and ethical issues that bear on the practice of rheumatology. It engages in this work with a team of volunteer members and through collaborations with ACR committees that handle related work, such as the Committee on Education and the Government Affairs Committee. CORC also includes two subcommittees—the Insurance Subcommittee (ISC) and the Affiliate Society Council.
“I’ve met a lot of great, like-minded volunteers through my work within the ACR over the years and look forward to collaborating with many of them, who are now spread across various roles within the College,” Dr. Phillips says. Here, he explains his plans to continue advancing the important work of CORC as its new leader.
The Rheumatologist (TR): Why did you decide to take on the role of CORC chair as your next volunteer position within the ACR?
Dr. Phillips: I am excited by this opportunity and honored to be given this role. Chairing CORC is a natural extension of the work I have done in the past. I served as a CORC member from 2016–2018 and then as chair of CORC’s ISC from 2018–2021. I also worked on the COVID Practice and Advocacy Task Force in 2020–2021 and served a brief stint with the Registries and Health Information Technology Committee from 2021–2023. The charge of CORC revolves around supporting the practice of rheumatology, especially our community practices. As an independent private practitioner, this new role serving the College is near and dear to my heart.
TR: What knowledge and experience do you bring to your new role as CORC chair?
Dr. Phillips: I’ve had a lot of conversations with community rheumatologists about their pain points, as well as with some of the payers creating those pain points, during my time on ISC. Rheumatologists are a small part of the medical community, but we are the gatekeepers to some very expensive and life-changing therapies. This puts a bullseye on our backs from payers and regulators. We have evidence-based guidelines to support how we use those treatments, but we increasingly find payers putting non-evidence-based barriers between us and our patients’ best outcomes in the name of cost savings. CORC will continue to provide rigorous support to our members who are trying to provide the best care for their patients, starting with the position statement platform that is one of CORC’s chief duties. These are official statements that reflect the policy of the ACR on issues related to the management of rheumatic and musculoskeletal conditions. CORC will also continue supporting the economics of our members’ practices in several ways, such as developing business-focused educational resources, because our practices need to stay afloat to provide this care.
TR: What insights from your own practice do you bring to CORC?
Dr. Phillips: As a small business owner and rheumatologist, I wear the same two hats many of our members do. With my business-owner hat on, I look at the bottom line—watching with concern when I see Medicare reimbursement rates not only failing to keep up with inflation, but actually being cut. These cuts, combined with the increasing cost of supplies and paying our staff, significantly tighten our margins. CORC supports the practice of rheumatology for our employed and academic members as well, but we know that especially for our independent members, we must remain highly active in advocacy with payers and the government for adequate reimbursement. This is important both for our evaluation and management codes and infusions, where lower administration fee reimbursement and an unstable market of biosimilar pricing have created increasing challenges in the last few years.
With my clinical practice hat on, I battle step therapy and prior authorizations, as well as burdensome documentation requirements, MIPS requirements and various other hurdles to providing my patients the care they deserve. These are the same pain points all of our members experience, of course—these are among the issues we seek to impact through CORC advocacy efforts.
TR: Can you share your plans and goals for CORC over the next couple of years?
Dr. Phillips: While our members are increasingly comfortable using biosimilars, we are finding on the buy-and-bill side that the economics are challenging. For example, several biosimilar versions of infliximab are reimbursed at rates below acquisition cost and are at the same time mandated for use by some payers. As we see more versions of more drugs, this issue may grow. This concern is closely wedded to the importance of supporting the buy-and-bill model of drug acquisition, which is critical to the survival of many of our members’ practices. These are issues that CORC, along with ISC, has been addressing aggressively for the last few years. I forecast our advocacy in these areas will need to further intensify.
I am excited by the formation of the Community Practice Council (CPC), and I anticipate CORC will increasingly work with this expert group of community rheumatologists to identify emerging concerns that warrant CORC’s focus. The more we connect with passionate members, the better pulse we have on the health of community rheumatology. I am hopeful we can work in tandem with the CPC and like-minded community practice groups outside of the ACR. I want to see CORC provide the best possible educational resources and support for members who are in the thick of dealing with the business of medicine and for those just starting out who need guidance on how to do this!
TR: What unique interests and experiences do you bring from outside of rheumatology that help you in your practice and volunteer work for the College?
Dr. Phillips: My time with my three teen boys keeps me happily busy outside of work. When I can find time between my family, my practice and my ACR work, I love to grab my bike or running shoes and hit the road to train. I just finished my sixth marathon and am training as usual for spring triathlon season. My time to myself running, biking or swimming is limited but important for me in order to reset and think through ideas I’m working on for my practice and my ACR work.
Carina Stanton is a freelance science journalist based in Denver.
