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Search results for: health insurance

President’s Corner: The Practicing Rheumatologist

Carol A. Langford, MD, MHS  |  April 5, 2025

Independent, community-based rheumatologists and rheumatology professionals represent a critical part of the ACR and ARP. My immense respect for clinicians grew while watching my husband, who joined an independent practice after completing rheumatology fellowship. With admiration, I saw how he and his two dedicated partners cared for patients while simultaneously managing overhead and striving to…

Filed under:Practice ManagementPractice SupportPresident's Perspective Tagged with:ACR CommitteesAdvocacyPresident's CornerRISE registry

Rheum After 5: Embracing Their Inner Swiftie

Linda Childers  |  March 7, 2025

Marked by their passionate support of Taylor Swift, several rheumatologists, rheumatology professionals and ACR staff who identify as Swifties spoke to us about their in-depth knowledge of Swift’s music and active engagement in fan discussions and events.

Filed under:ProfilesRheum After 5 Tagged with:Cheryl CrowDr. Intelly LeeDr. Jean LiewDr. Noelle RolleJennifer EastinLacey Feigl-LenzenStarla Blanks

The Transition from a Rheumatology Fellowship to Private Practice

Tom Berry, DO  |  March 6, 2025

The transition from being a rheumatology fellow to being in private practice is significant. As I reflect on the past two years, I want to share my observations and begin a conversation about how to prepare rheumatology fellows for careers as practicing rheumatologists. The difference between learning about rheumatology and practicing rheumatology is nuanced. Upon…

Filed under:CareerCareer DevelopmentCareer DevelopmentOpinionPractice ManagementPractice SupportSpeak Out Rheum Tagged with:Fellowsrheumatologist fellows

Psoriatic Arthritis

In the Details: Diagnosing PsA Requires Drilling Down

Vanessa Caceres  |  February 26, 2025

Rheumatologists must do some detective work into a patient’s signs and symptoms when considering a psoriatic arthritis diagnosis, according to Philip J. Mease, MD, MACR

Filed under:ConditionsPsoriatic Arthritis Tagged with:ACR on AirEnthesitispatient carepodcastPsA

ACR Comments on Proposed Medicare Advantage Changes

From the College  |  February 10, 2025

In response to proposed changes to the Medicare Advantage and prescription drug programs for contract year 2026, the ACR submitted comments on the provisions related to the Inflation Reduction Act, prior authorization and the influence that pharmacy benefit managers have on the placement of biosimilars on formularies.

Filed under:InsuranceLegislation & AdvocacyPractice Support Tagged with:ACR advocacyInflation Reduction ActMedicare Advantagepharmacy benefit managers (PBMs)

Editor's Pick

The Burden Imposed by Prior Authorization Requirements

Deborah Levenson  |  February 9, 2025

‘Prior authorizations are the bane of our existence as rheumatologists,’ says Physician Editor Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS. ‘How bad is it, how can we manage them, and how is the ACR helping?  Read on in this month’s Editor’s Pick.’ Healthcare providers consider prior authorization (PA) a significant burden, but to different degrees…

Filed under:Patient PerspectivePractice SupportTechnology Tagged with:artificial intelligenceprior authorization

Rheumatology 2025 State Legislative Preview

Joseph Cantrell, JD  |  January 20, 2025

As state legislatures begin to convene their sessions in 2025, several key issues related to rheumatology are expected to take center stage, including drug costs, utilization management, telehealth and copay accumulators.

Filed under:From the CollegeLegislation & Advocacy Tagged with:state legislation

Adobe Stock | Creativa Images

RA: How High Is the Toll?

Samantha C. Shapiro, MD  |  January 9, 2025

Patients with RA not only suffer from functional limitations, but also face increased healthcare costs, primarily due to prescription drug use, says Dr. Yinan Huang.

Filed under:ConditionsResearch RheumRheumatoid Arthritis Tagged with:economic burdenMSPhDphysical burdenRA Resource CenterYinan Huang

What Providers & Patients Should Know About Medicare Benefit Changes in 2025

From the College  |  December 9, 2024

Changes to Medicare benefits in 2025 include an annual $2,000 cap on out-of-pocket costs for covered Part D drugs and a new, voluntary Medicare Prescription Payment Plan intended to help beneficiaries manage drug costs.

Filed under:Insurance Tagged with:Medicare Part Dprescription drug costs

The Ethical Tug-of-War Over Biosimilar Adoption

Karen Ferguson, MS, & Richard L. Allman, MD, MS, FACP, FACR  |  December 9, 2024

The advent of biosimilar medications has offered the promise of significant cost savings for healthcare systems and patients. Biosimilars are highly similar versions of existing biologic drugs, providing a more affordable alternative once the original biologic patent expires. However, the adoption of biosimilars in the U.S. has been hampered by myriad roadblocks, many of which…

Filed under:Biologics/DMARDsDrug UpdatesEthicsGuidance Tagged with:BiosimilarsEthics ForumMedical necessitypharmacy benefit managers (PBMs)

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