How do healthcare providers enable positive outcomes for their pediatric patients while also addressing the disparities in care between patients of different ethnicities, gender and socioeconomic backgrounds? Experts addressed how changes in research and clinical care can improve outcomes for children experiencing healthcare disparities during a session at the 2023 Pediatric Rheumatology Symposium.
During a busy start to 2023, the ISC has been advocating with payers to address multiple coverage and reimbursement challenges facing rheumatology practices, including Cigna’s modifier 25 requirements, hydroxychloroquine access and coverage for apremilast combination therapy.
A recent meeting of the National Council of Insurance Legislators (NCOIL) featured discussions of many topics important to ACR members, including pharmacy benefit manager legislation, biomarker testing and transparency in the healthcare market.
The U.S. government remains divided. Democrats hold the White House and the Senate by one vote, and Republicans lead the House. Amid this division, the ACR is watching possible areas to advance healthcare legislation. Meet the committees and members with the largest jurisdiction over healthcare policy.
PHILADELPHIA—Quality improvement (QI) tools in pediatric rheumatology can help overcome health outcome disparities that are based on race, gender identity, income and other factors, experts said in a session at ACR Convergence. With it well established that these disparities exist, it’s time to begin eliminating them, said Emily Smitherman, MD, MS, assistant professor of pediatric…
During an ACR webinar in August, presenters discussed multiple aspects of telehealth in rheumatology, especially related to rheumatology fellowship training. They agreed that although telehealth represents one potential avenue to improve patient access to treatment for rheumatic disease, we must keep identifying the best ways to employ telehealth to enhance care. Impact of Pandemic Telemedicine…
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
Because rheumatologists and mental health experts both treat patients with depression, anxiety, pain, disability and sleep disorders, provider cross-training may benefit patients and providers themselves. “When a patient has active psychosocial distress, this has a negative effect on their physical function. Similarly, if a patient has active physical symptoms, like a rheumatoid arthritis flare, this…
The ISC has worked with CVS Caremark to revisit changes to its prior authorization forms that would have increased the administrative burden on practices, and patients with Blue Cross Blue Shield of South Carolina may not have to worry about switching to a self-administered biologic.
Rheumatology practices have a voice in payer advocacy through the Insurance Subcommittee of the ACR’s Committee on Rheumatologic Care.