ACR CONVERGENCE 2021—Advocacy leaders for the ACR outlined a host of victories and challenges in a session at ACR Convergence 2021, while underscoring the importance of member involvement to help drive policy changes that will help rheumatologists and their patients.
Dr. Blair Solow
Elizabeth (Blair) Solow, MD, chair of the ACR Government Affairs Committee, outlined several big wins that resulted from the College’s advocacy efforts during the past year. Those achievements include maintenance of recent gains in evaluation and management coding in the CY2022 Medicare Physician Fee Schedule Final Rule, as well as extended flexibilities for telehealth and acceptance of the rheumatology-specific Merit-Based Incentive Payment System (MIPS) Value Pathway, which will simplify rheumatologists’ participation in MIPS.
In addition, the Pediatric Subspecialty Loan Repayment Program was reauthorized this year, with $25 million proposed to fund the program for the first time. “If we can get this through appropriations, this will be a huge win for our pediatric colleagues,” Dr. Solow said.
Advocacy Hill Days in May and September—attended by nearly 200 ACR members, rheumatology professionals and patients in total—were particularly effective, Dr. Solow said. Groups spoke with members of Congress and their staff about step therapy, prior authorization policies, and drug pricing issues and their effects on practices and patient access to care. Since those meetings took place, ACR staff and volunteer leaders have noted increased awareness and co-signers on related bills.
Current efforts are directed toward blocking the significant cuts to Medicare reimbursement scheduled to take effect at the beginning of 2022. Lennie McDaniel, JD, director of congressional regulatory affairs for the ACR, said the College is working to avoid these cuts, which would amount to nearly a 10% reduction in Medicare reimbursement rates for providers, including rheumatologists.
Dr. Solow encouraged all providers to send letters to their representatives to support a legislative fix for these cuts, saying, “This is incredibly important to move the needle and push these policies forward.”
Looking Ahead
With the focus of Congress over the past several months on big spending bills that are the cornerstone of President Biden’s agenda, there has not been much opportunity to focus on other, more specific legislation, Ms. McDaniel noted.
“Our hope is once we turn over the new year, those things will have been resolved and we can go back to focusing on some of the more one-off, specific topics that really drill down and deal with issues specific to day-to-day practice and patient care,” she said.
Amanda Wiegrefe, MSc, the ACR’s director of regulatory affairs, said one of the more favorable developments since President Biden took office is the extension of telehealth flexibilities through 2023.
“This allows us to spend much of next year working with the Centers for Medicare & Medicaid Services to look and see which parts of these telehealth flexibilities will continue to work and which parts may not be appropriate in a post-pandemic world,” Ms. Wiegrefe said. “The ACR certainly believes that telehealth is a great supplement for patients and providers, but it is not a substitute for in-person care, and we will be sure that is crystal clear when we have this conversation.”
Another big relief was the proposed elimination of the Most Favored Nation model in drug pricing, which was ostensibly meant to lower drug pricing but raised concerns about access to care, Ms. Wiegrefe said.
On the coronavirus front, the ACR will continue to advocate for immunocompromised individuals to be granted early access to vaccinations, she said.
Patient Perspective
Amy Barron, RN, a retired medical professional and woman with rheumatologic disease who has become an outspoken advocate for patients, said advocacy has dramatically changed her life for the better. Having had 15 rheumatic illnesses—10 of which she was actively managing at the time of the talk—she took notice of a brochure about an arthritis event. That sparked her interest, leading her to help with petition drives and to frequent visits to the offices of government leaders.
“I realized I was the best person to tell my personal story. If I didn’t tell my representatives in Congress my story, who would?” Ms. Barron asked.
She suggested that those considering becoming involved in advocacy follow the lead of the ACR—and other organizations—sign up for action alerts and not to be afraid to ask government representatives for support.
“Many times, your representative is not aware of a particular issue unless a constituent brings it to their attention,” Ms. Barron said. “You might be the first person to approach them about arthritis legislation.” She emphasized that arthritis policy is a non-partisan topic and that politics should be avoided in interactions with government leaders. But she said to remember that the “representatives work for you” and “you’re the expert about arthritis.”
Working in advocacy builds self-esteem and confidence, benefits the wider community and fulfills the duties of citizenship, she said.
“Advocacy gave me a new purpose and perspective on life,” Ms. Barron said.
Every Member Can Help
Dan Redinger, the ACR manager of advocacy and policy affairs, said that simply educating yourself about how public policy can affect rheumatology is a great first step in getting involved. Easy ways to stay informed are to read the bimonthly ACR@Work newsletter and to follow the ACR’s advocacy Twitter account, @ACRheumDC.
Time is never in ample supply, but there are quick ways you can make a difference, Mr. Redinger said. From the ACR’s Legislative Action Center, members can send pre-written letters directly to federal and state legislators; it just takes a few seconds to send your message and only a minute or two to customize it, if you so choose.
“We try to make it as easy as possible,” he said.
There are also opportunities for committee involvement, and visits to Capitol Hill are effective and a fun way to share your message, Mr. Redinger said.
“While the ACR and its advocacy staff are working with legislators on your behalf every day, it’s critical for them to hear from constituents directly,” he said. “The ultimate goal is that you should be seen as a resource for that member of Congress,” providing an important physician perspective to help representatives make informed policy decisions. Making that happen “takes consistent communication,” he said.
“We want you to turn your frustration into action,” Mr. Redinger said. “There are a lot of things that are going on in your practice and with your patients that can be extremely frustrating. And we want you to know that the ACR is here to help and give you the resources you need to be a good advocate.”
Thomas Collins is a freelance medical writer based in Florida.
