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Changing Loan Limits for Advance Practice Providers

Jack Cush, MD

The "One Big Beautiful Bill" (OBBB), or H.R. 1, was signed into law in July, calls for significant changes in the funding of healthcare education.  This bill that lowers cap limits on education loans applies to graduate (APRN, PA) programs.

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Legislative Issues Affecting APPs

Jack Cush, MD

Here's a summary of legislative issues in three key areas: APRN compact and interstate licensing hold up; scope of practice; and, reimbursement hassles.

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Long-Term APP Retention: Building Success for Practices and Providers

Lindsay Tom PA-C

Advanced Practice Providers (APPs) play an increasingly vital role in rheumatology practices across the country. With rising patient volumes and a growing demand for timely, high-quality care, incorporating an APP into a rheumatology team can be transformative.

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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients

Jack Cush, MD

More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the perioperative management of DMARDs and found inconsistencies and low quality evidence, with great reliance on conditional (expert opinion) recommendations.

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Nurse-Led Treat-to-Target Clinics

EurekAlert!

New studies shared at the 2025 annual EULAR congress in Barcelona highlight the benefits that nurse-led care can bring for both patients and healthcare systems.

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ERA, APPs, & Alpha GAL (3.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

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NP and PA Growth in the USA

Jack Cush, MD

Forbes has published a thoughtful perspective on the declining number of US physicians and the growth in the number of advanced practice providers or APPs (nurse practitioners and physician assistants) in the US clinical workforce. Gastroenterologist Dr. Spencer Dorn writes that in the US, there are fewer physicians per capita (2.6 per 1,000) than most developed nations (average 3.6 per 1,000), with a physician shortfall of 125,000, that is projected to be ~200,000 by 2037.

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Alive in 2025 (1.10.2025)

Jack Cush, MD

Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com

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Long-Term APP Retention: Building Success for Practices and Providers Advanced Practice Providers (APPs) are vital in rheumatology due to rising patient numbers and the need for prompt care. Their integration enhances practice efficiency, improves patient access, and balances https://t.co/bZBkbWyWfI
Dr. John Cush RheumNow ( View Tweet)
ACR Applauds Bipartisan Support for Prior Authorization Reform Bill The ACR commended the more than 295 bipartisan, bicameral cosponsors of The Improving Seniors’ Timely Access to Care Act, which, if enacted, would reform the prior authorization process for Medicare Advantage https://t.co/n0MKkSqRwO
Dr. John Cush RheumNow ( View Tweet)
CDAI appropriately guided therapy escalation in RA, but not for everyone. Treatment adjustments were less likely in pts with public or no insurance. Even data-driven care can fall short when access barriers persist. @RheumNow #ACR25 Abstract#2616

Jiha Lee JihaRheum ( View Tweet)

Paging the pharmacist Abstract 1973: Dedicated clinic pharmacist -> benefits Tasks included: 🔹 74% PA support 🔹 55% patient education 🔹 40% medication management ~50% pts had clinically meaningful improvement Providers report ↑ care quality & ↓ admin burden @RheumNow #ACR25

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

ADA-biosimilar use surged just before CVS formulary change then dropped sharply after. In RISE data, uptake reached 25% of users overall. Formulary policies reshape prescribing, but sustaining adoption needs alignment with patient access and preferences. @RheumNow #ACR25 A#1042

Jiha Lee JihaRheum ( View Tweet)

ACR Urges Alaska and Montana to Strengthen Rheumatology Care The American College of Rheumatology (ACR) is calling on Alaska and Montana to seize the opportunity to address critical gaps in rheumatology care by accessing funding from the Rural Health Transformation Program https://t.co/exHRCORcCG
Dr. John Cush RheumNow ( View Tweet)
AMN Healthcare report on MD salaries -- high demand for specialist MDs w/ RHEUM the 7th Most In-Demand. 2024/205 Rheum were low of $214K, a high of $450K, median of $341,000. Avg salary for NPs is $180K up from $164,000 last year, a 9.6% increase. https://t.co/NcmwrMxpKr https://t.co/a86NvQhZry

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Dr. John Cush RheumNow ( View Tweet)
CMS to Test Prior Authorization Model in Traditional Medicare The Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some politicians and experts https://t.co/o8iV9Bb6Ir
Dr. John Cush RheumNow ( View Tweet)
ACR & Arthritis Foundation Denounce the Dismantling of Vital Health Programs As organizations representing nearly 60 million adults and children living with arthritis in the United States and the rheumatologists and health care professionals who treat them, we are deeply https://t.co/VH3hPz115f
Dr. John Cush RheumNow ( View Tweet)
#JIA #biologics and #tsDMARDs: Are all patients getting the same access? MDTs, share your insights on on-label and off-label prescribing and help improve future care. 💬 Take the survey by 15 April: https://t.co/vC2Pv5vmH4 https://t.co/rRM5rH0QQl

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BSR RheumatologyUK ( View Tweet)
Peripheral Nerve Blocks for Hip Fractures JAMA reviews the use of peripheral nerve block with hip fractures as an effective pain management strategy that can be performed by credentialed clinicians outside of the operating room. https://t.co/baeLWVxeUo https://t.co/ZBTVDT0jGR

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Dr. John Cush RheumNow ( View Tweet)
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