ACR Releases State-by-State Rheumatic Disease Report Card Save

The American College of Rheumatology (ACR) today released the Rheumatic Disease Report Card: Raising the Grade on Rheumatology Care in America, a first-of-its-kind report that evaluates just how difficult it can be to live well with a rheumatic disease in the United States.

The Rheumatic Disease Report Card provides actionable information to healthcare consumers and policymakers in all 50 states and the District of Columbia by answering the question, “How easy is it to live with a rheumatic disease in my state?” The report assigns states letter grades according to their progress in providing adequate access to rheumatology care, ensuring rheumatic disease care is affordable, and encouraging healthy lifestyle habits that ease the burden of rheumatic disease.

The average state grade was a “C,” with Maryland earning the highest grade and Oklahoma and Alabama earning the lowest grades in the report.

“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,” said David Daikh, MD, PhD, President of the ACR. “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.”

The report findings indicate that all states have room to improve the access, affordability, and lifestyle factors associated with an individual’s ability to live well with a rheumatic disease.

A severe rheumatology workforce shortage, lack of insurance coverage and delays caused by restrictive insurer practices make it difficult for patients in many states to access rheumatic disease care. Even in states where patients can find a rheumatologist, their prescribed treatment costs are often exorbitantly expensive, as few states have taken measures to curb secretive pricing practices employed by Pharmacy Benefit Managers (PBMs) or put limits on insurers’ use of specialty tiers that implement high cost-sharing models. Furthermore, the report shows that policymakers at all levels of government can do more to make funds available for evidence-based rheumatology intervention programs like those funded by the CDC, and to support access to these programs in rural and underserved communities.

Of the 50 states and one federal district featured in the report, several states stood out as examples that others should look to as models for improving the lives of Americans with rheumatic diseases:

• Maryland was the only state to receive an overall “A” grade due to its success in having a high concentration of rheumatologists, a low uninsured rate, laws in place to keep rheumatology care affordable, and several CDC-funded arthritis intervention programs operating in the state, including those offered by the YMCA and the National Recreation and Parks Association (NRPA).
• Arkansas scored well in the affordability category due to state lawmakers’ recent efforts to address PBM transparency by enacting legislation that should serve as a model for future action in other states looking to address this issue.
• Arizona received distinction for its efforts to educate primary care physicians in remote areas about rheumatic diseases so these frontline healthcare workers can better monitor and treat minor cases locally while referring more severe cases to a practicing rheumatologist. Arizona has one of the lowest concentrations of rheumatologists in the country, with only one practicing rheumatologist for every 139,000 people. Meanwhile, in Massachusetts and Maryland, there is one rheumatologist for approximately every 20,000 people – a ratio nearly seven times higher.
• "A" grade: 1 state (MD)
• "B" grade: 16 states
• "C" grade: 34 states
• "D" grade: 2 states (OK, AL)

Rheumatic diseases are painful autoimmune and inflammatory diseases that affect a person’s joints, muscles, bones, and organs. There are more than 100 types of rheumatic diseases, including the more commonly known diseases of osteoarthritis, rheumatoid arthritis, lupus and gout.

One in four Americans are diagnosed with a rheumatic disease, and a recent academic study suggested that the number of Americans living with rheumatic disease may be as high as 91 million when taking into account reported symptoms of undiagnosed individuals. The prevalence and cost of rheumatic diseases represent a growing public health crisis. As the nation’s leading cause of disability, rheumatic diseases generate more than $140 billion in medical costs each year in the United States – surpassing the annual medical costs of cancer care.

“Rheumatic diseases can be debilitating - but they don’t have to be if a diagnosis is made without delay and appropriate treatment is started,” said Dr. Daikh. “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.”

The Rheumatic Disease Report Card is a project from the American College of Rheumatology (ACR) and its Simple Tasks™ public awareness campaign. Its development was guided by a national task force comprised of leading rheumatology researchers, clinicians and policy experts.

To view the Rheumatic Disease Report Card, please visit simpletasks.org/reportcard.