The American College of Rheumatology gave Massachusetts an overall “C” grade in its report titled “Rheumatic Disease Report Card: Raising the Grade on Rheumatology Care in America.” This is the overall grading more than half of U.S. states received from the organization.
This is an update from a report originally made in 2018. The report stated that the changes in grades had to do with whether “new policies [were] enacted since 2018 to improve conditions for people living with a rheumatic disease. As a result of these policies, some states saw substantial changes in their scores for 2022.”
According to the report, there are more than 100 types of rheumatic diseases that are “autoimmune, inflammatory, and degenerative diseases that affect a person’s joints, muscles, bones, and organs.” These include common diseases like “osteoarthritis, rheumatoid arthritis, lupus, and gout.” Numbers from the Centers for Disease Control and Prevention (CDC) state that an estimated 58.5 million American adults have “doctor-diagnosed arthritis,” and the report projected that the number of rheumatologists will decrease compared with the expected growth in demand.
The report split up its grading based on the three categories of accessibility, affordability, and activity and lifestyle, for which Massachusetts earned a C, F, and A grade, respectively. For accessibility, “states that received higher grades have enacted policies that limited insurance companies’ use of step therapy and prior authorization, practices that make it more difficult for patients to access needed medication, and have been shown to delay medically necessary treatments and contribute to adverse outcomes for patients. They also typically had fewer people per available rheumatologist, and a low uninsured rate.” Affordability measured whether “state policy efforts to curtail health insurers’ use of drug specialty tiers and copay accumulators, and to regulate abusive PBM (pharmacy benefit management) business practices that drive up costs for patients,” and Massachusetts was one of 20 states to receive an “F” grading. For activity and lifestyle, most states that received an “A” grading, like Massachusetts, “had a low prevalence of activity and lifestyle limitations due to arthritis or another rheumatic disease, and low rates of physical inactivity” and the report also “tracked the presence of CDC-funded arthritis activity programs.”
Healthy Aging Martha’s Vineyard executive director Cindy Trish said the ratings don’t surprise her at all.
“Access to healthcare can be an issue for older adults, especially when they need to go off-Island. I don’t know too much about rankings for affordability, but we do know that incomes [here] are lower than [the] state average, and costs to live on the Island are higher than the state norm,” Trish said. “But, no surprise there,”
The Older Adult Transportation Summit that took place in September showed there are options on-Island to help elderly Islanders get to where they need to go.
Trish also said, “Our data support the lifestyle/activity ratings you see for Massachusetts,” which she believes is “probably higher here than in more urban areas.”
Those who have a rheumatic disease can receive treatment at Martha’s Vineyard Hospital.
“At Martha’s Vineyard Hospital, we treat moderate to severe rheumatic diseases. Our providers and patients are able to connect with Mass General rheumatologists for physician-to-physician consults or telehealth appointments. Depending on the unique needs of the patient, our providers may also refer patients to see a rheumatologist within the Mass General Brigham system,” Martha’s Vineyard communications manager Marissa Lefebvre said. “MVH offers on-site infusion services to treat many rheumatic diseases.”
When asked whether this grading was available at the town or city levels, American College of Rheumatology public relations specialist Amanda Head said, “Unfortunately, we do not have a rheumatic disease report card for cities and towns. The legislative efforts focused on the report card could only be passed at the state level.”
“We recommend community members talk with their local representatives to ensure that they are supporting state legislations in the areas outlined on the report card,” Head said.