Maryland is alone at the top of the rheumatology care class, but the number of failing states is even smaller, according to the American College of Rheumatology.
Maryland was the only state to earn an A on the “Rheumatic Disease Report Card,” and while no state failed, two – Alabama and Oklahoma – did receive Ds. Among the 47 other states and the District of Columbia, there were 14 Bs and 34 Cs.
Maryland posted strong scores in all three of the report card’s broad categories of care: 38.25 out of 50 points (third among all states) for access, 35 out of 50 (tied for first with New York) for affordability, and 40 out of 50 (tied for ninth) for activity/lifestyle. Arkansas had the highest score (42.25) for access and Nebraska got 50 out of 50 for activity/lifestyle. Inferiority, however, turned out to be a lot more widespread, as eight states were tied for the low of 10 points in the access category, 26 states got a 0 for affordability, and six states earned 15 points for activity/lifestyle, the ACR said.
Arkansas’s high marks for access were based primarily on “state lawmakers’ recent efforts to address [pharmacy benefit manager] transparency by enacting legislation that should serve as a model for future action in other states looking to address this issue,” ACR officials said in a statement. Nebraska did well in both of the measures used in the activity/lifestyle category – age-adjusted prevalence of arthritis attributable activity limitations among adults and percent of adults who are physically inactive; it also did well because it is home to at least one YMCA-sponsored and one National Recreation and Park Association–sponsored arthritis intervention program funded in part by the Centers for Disease Control and Prevention.
Patients across the country face a shortage of rheumatologists, the ACR noted, and the situation is expected to get worse in the coming years as demand increases and supply decreases. The college’s projections show that almost 6,800 rheumatologists will be needed by 2020 but less than 4,500 will be available, and by 2030 the demand will rise to need for almost 8,200 rheumatologists, while supply is expected to drop below 3,500, according to the report.
“We are at a critical juncture in rheumatology care. The rheumatology workforce is not growing fast enough to keep up with demand and too many of our patients struggle to access and afford the breakthrough therapies they need to manage pain and avoid long-term disability,” ACR President David Daikh, MD, PhD wrote in the report.