September 04, 2018
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ACR report card: Majority of states score 'C' for rheumatology care

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David Daikh

The 2018 Rheumatic Disease Report Card: Raising the Grade on Rheumatology Care in America released today by the American College of Rheumatology demonstrates that access to affordable rheumatology care varied considerably from state to state, with most states averaging a “C” grade.

Intended to provide actionable information to health care consumers and policymakers nationwide, the Rheumatic Disease Report Card assigns each state a letter grade based on their progress in providing access to rheumatology care, ensuring rheumatic disease care is affordable and fostering healthy lifestyle behaviors to ease the burden of rheumatic disease.

“This report comes at a critical time, as countless Americans living with chronic rheumatic diseases are finding it increasingly difficult to afford their prescription medications and even have access to specialized rheumatologic care,” David Daikh, MD, PhD, president of the ACR, said in a press release. “This report card is an opportunity for Americans to advocate for themselves and their loved ones by raising awareness and encouraging policymakers to enact policies that improve rheumatic disease care access and affordability.”

Developed in conjunction with a national task force comprised of leading rheumatology researchers, clinicians and policy experts, the report card evaluated individual states based on factors such as the number of people per rheumatologist, the percent of residents who do not have health insurance coverage and the prevalence of arthritis. Additionally, the report tracked the strength of state legislation addressing step therapy and pharmacy benefit manager transparency, with states receiving partial credit for laws that met certain criteria.

According to the report card, improvements in rheumatology care are desperately needed to increase the quality of life for people living with rheumatic diseases nationwide. The vast majority of states received either a B or C grade, while two states – Alabama and Oklahoma – received a D grade.

Although only Maryland received an overall A grade due to the combination of a high concentration of rheumatologists, a low uninsured rate and laws to maintain affordable rheumatology care, Arkansas and Arizona, despite their C-grades, stood out as models for other states looking to address disparities in rheumatology care:

  • Arkansas : Scored well in the affordability category because of state lawmakers’ recent efforts to address pharmacy benefit managers’ transparency by enacting legislation.
  • Arizona : Received distinction for efforts to educate primary care physicians in remote areas about rheumatic diseases so they can better monitor and treat minor cases locally while referring severe cases to rheumatologists — a necessary solution as Arizona has one of the lowest concentrations of rheumatologists in the country, with only one practicing rheumatologist for every 139,000 people.

“Rheumatic diseases can be debilitating — but they don’t have to be if a diagnosis is made without delay and appropriate treatment is started,” Daikh said in the release. “We hope this report will help people understand that they have the power to turn the tide on this public health crisis by taking steps to raise their state’s grade on rheumatic disease care.”

To view the Rheumatic Disease Report Card, visit SimpleTasks.org/ReportCard.