Over 150 rheumatologists and practice administrators gathered for United Rheumatology’s 2019 Spring National Meeting in Dallas, TX. “Mitigating Practice Risk as the Healthcare Landscape Shifts Beneath Us” addressed the major challenges independent providers currently face, and more importantly, how United Rheumatology and its members can be a part of the solution. With 550 members in 37 states, United Rheumatology is the largest network of community-based rheumatologists in the United States. Attendees learned about UR’s full portfolio of services that are designed to support and sustain independent practices, as well as how UR is actively engaging payers on behalf of its membership.
Drs. Michelle Petri, Director of the Hopkins Lupus Center and Professor of Medicine at Johns Hopkins University School of Medicine and Evan Siegel, Medical Director of Arthritis and Rehabilitation Therapy Services for Arthritis and Rheumatism Associates, P.C., opened the meeting with their presentations at the welcome dinner on Friday evening.
Dr. Petri shared the Lupus Low Disease Activity State (LLDAS), a newly developed tool to measure disease activity in SLE patients. The LLDAS is an important tool that will allow providers to gauge the effectiveness of current and future therapies and is aimed at preventing organ damage that is common in SLE patients. Dr. Petri is collaborating with United Rheumatology on integrating UR member data capture of the LLDAS. As the first organization in the country to adopt this critical quality measurement UR and Dr. Petri are embarking on a a dramatic shift in the clinical measurement of lupus care. In addition to sharing the LLDAS, Dr. Petri discussed the American Academy of Ophthalmology’s (AAO) recent recommendation regarding hydroxychloroquine therapy, providing a detailed review of how their guidelines are based on a potentially compromised study.
Dr. Siegel delivered the latest information on psoriatic arthritis and ankylosing spondylitis, including the effectiveness of monoclonal antibody therapeutics. He shared data on the average length to diagnosis for ankylosing spondylitis — 8 years for men, and 11 years for women and what the delay in diagnosis and treatment means for patient outcomes. He described psoriatic arthritis as a systemic disease that is underdiagnosed, and urged members to form relationships with dermatologists and podiatrists in order to provide more holistic care.
Congressman Michael Burgess (R-Texas) provided the keynote address for the National Meeting sharing his critical insights on the current state of provider reimbursement and what the future might hold. As the most senior physician on both sides of the aisle with over three decades of clinical experience, he is an ardent supporter of the independent practice of medicine. He discussed the implementation of the Medicare Access and Chip Reauthorization Act, which replaced the Medicare’s Sustainable Growth Rate and will pay providers based on value and quality of care provided. He also acknowledged that more work needs to be done in order to accommodate new and future treatments.
Additional presentations included round table sessions delivered by UR’s leadership team, as well as the following:
- Dr. Daniel Aletaha, Associate Professor of Medicine and Consultant Rheumatologist, Division of Rheumatology, Medical University Vienna, Austria, presented on treat-to-target and precision-based medicine. Dr. Aletaha emphasized the importance of early recognition and treat-to-target strategies in achieving favorable patient outcomes in PsA. He also discussed the adoption of precision-based medicine in rheumatoid arthritis, pointing to the recent availability of large-scale biologic databases, powerful methods for characterizing patients and computational tools for analyzing large sets of data. Precision-based medicine plays a role in diagnostics, therapeutics and prognostics for patients with rheumatoid arthritis.
- Dr. Charles Pritchard from Rheumatology Specialty Center and a UR member since 2017, covered primary medication nonadherence. With multiple studies documenting patient primary non-adherence to a biologic is as high as 40%, the project will attempt to demystify these data by drilling into practice workflows including the barriers of Prior Authorization and the associated delays in care that may result in impacting patient adherence. In addition to Dr. Pritchard’s large practice model, UR will also be engaging a solo practitioner to identify if variances in workflow, due to scale of staffing, is a determinant.
- Dr. Adrienne Hollander from Arthritis, Rheumatic & Back Disease Associates and a UR member since 2015, provided a comprehensive update at the one year anniversary of her exciting health plan pilot.