Update from the Board
The ACR Board of Directors met August 3-5, 2006 in Washington, DC . Invited guests from governmental agencies and voluntary health organizations met with the Board to describe areas of current work. Opportunities for ACR and its members to collaborate with these agencies were suggested by our guests and board members. At the same time, the budgetary realities that constrain the federal agencies were a recurrent theme. Outstanding presentations from the Food and Drug Administration, the Centers for Disease Control, the American College of Physicians, the American Medical Association, and the Arthritis Foundation stimulated the Board to consider several new projects. The Board's discussion included:
- Legislative issues affecting rheumatology and the possible formation of a Political Action Committee
- Drug safety and the FDA's Critical Path Initiative
- Public health issues in rheumatology
- The College's new publication that will launch in November
- Reimbursement reform and its relation to the quality movement, including ACR's quality initiatives
Reports from various committees
The Board consulted with representatives from the American College of Physicians and Patton Boggs, our lobbyists, regarding the formation of a Political Action Committee. The member benefit of forming an ACR PAC would be increased interactions with members of Congress, including opportunities to engage in discussions about issues important to rheumatologists and our patients. The Committee on Government Affairs reported the results of a recent member survey to gauge the value members would place on an ACR PAC. The survey results indicated that a majority of members did find significant value in creating a Political Action Committee. The Board decided to continue to solicit feedback from membership regarding the possible formation of a PAC at the Annual Scientific Meeting in November.
Steve Abramson, MD, the Chair of ACR's Drug Safety Committee, presented an overview of progress in developing joint activities between the Drug Safety Committee and the FDA, including a planned drug safety symposium at ACR's Annual Scientific Meeting. Potential future collaborative projects include a rheumatology-specific Web page on the FDA's Web site, a joint ACR/FDA workshop on drug safety, and communication between the Quality Measures Committee and the FDA as ACR outcome measures, disease classification criteria and guidelines are developed. Janet Woodcock, MD, Deputy Commissioner for Operations for the FDA, had the Board fully engaged when she presented an outstanding review of the FDA's current activities. The FDA's approach is to stimulate development of new therapies and understand drug toxicities through research that takes a personalized medicine view. Dr. Woodcock has led the development of the FDA's Critical Path Initiative, addressing biomarker qualification, clinical trial modernization, bioinformatics, modernizing manufacturing, pediatric treatments, and public health emergencies. As a rheumatologist, Dr. Woodcock clearly understands the challenges of developing therapies for patients with complex rheumatic diseases as well as those with common arthritis conditions, and she suggested several areas of possible ACR and FDA collaboration related to the Critical Path Initiative. ACR's Committee on Research was asked to work on developing proposals for collaboration with the FDA in this area.
Wayne Giles, MD, MS from the CDC discussed a public health approach to arthritis. He emphasized the high morbidity rates of arthritis and other musculoskeletal diseases and the disproportionate lack of funding. Dr. Giles stressed the need for self management education programs for patients. The ACR Board agreed that further collaborative efforts between the CDC, ACR, and Arthritis Foundation would help to advance the goal of public awareness and better government funding for arthritis and other musculoskeletal diseases. The possibility of formalizing patient education programs in the setting of clinical practice through collaborative efforts of ACR's Committee on Rheumatologic Care and the Association of Rheumatology Health Professionals was suggested.
Senior Vice President of Government Affairs and Public Policy for the American College of Physicians, Bob Doherty, presented an overview of the current legislative climate regarding physician reimbursement reform. Mr. Doherty explained that the ACP was in the process of developing a possible alternative reimbursement model, called the Advanced Medical Home model, which offers a way of organizing, delivering, and financing care that is centered on the needs of patients and incorporates elements of the chronic care model. He invited the ACR to provide input to the model from a rheumatology perspective during their upcoming public comment period.
The Committee on Rheumatologic Care addressed the proposed reimbursement cuts to DXA and the various avenues the ACR is taking to mitigate the payment decrease. ACR is partnering with several other specialty organizations on multiple levels to try to prevent the reductions from taking place. CORC also presented a position statement on Biologic Agents for Rheumatic Diseases, which was approved.
David Pisetsky, MD, PhD, the first editor of the College's new publication, The Rheumatologist , reported on the progress of selecting his editorial team and creating the debut issue for November 2006. The publication will be accessible, readable and present actionable content, and Dr. Pisetsky expressed his enthusiasm for working on a project that will be an interactive experience between the College and its membership. The editorial team will actively encourage ACR and ARHP members to provide ideas for content and author certain articles. Some topics to be covered in TR include clinical trials, practice management, rheumatology trends, quality, public policy, research, health professional issues, drug safety, and career development.
The Quality Measures Committee and the Quality Leadership Council updated the Board on several of ACR's quality initiatives. The QMC had organized a Rheumatology Quality Stakeholders' Summit , which had occurred just prior to the Board meeting. The goals of the meeting were to demonstrate ACR's quality initiatives, learn about what other organizations were doing in terms of quality and generate opportunities for coordination of efforts and collaboration of resources. The meeting was a great success and further developed the goal of advancing the ACR as the organization representing the interests of rheumatologists in the quality movement. The Board also discussed the results of a recent member survey regarding the quality movement. The survey revealed members' concerns about the implications of the quality movement for physicians and their patients; however, there was a strong mandate from membership for ACR to engage in the quality movement on behalf of rheumatologists. The QMC also presented a draft of the RA Response Criteria, which was approved.
The Committee on Training & Workforce Issues presented a preliminary draft of a report to address the results of the Rheumatology Workforce Study. The results of the study will be released in conjunction with the ACR's annual meeting in November. The ARHP updated the Board on the NP/PA Post-graduate Rheumatology Training Program, which is on target for delivery in fall 2007. The ACR Board agreed that many ACR members would find value in encouraging their staff to participate in this program once it is available. The Committee on Nominations and Appointments presented the new Masters, Awards of Distinction, and ACR committee nominees for 2006 for approval; they were approved. Among the committee nominees approved were a chair and at-large committee members of a new Communications and Marketing Committee. The committee is charged with coordinating the communication of progress in the diverse areas of ACR work as well as important issues related to ACR's interactions with external groups. ACR membership will vote on the Executive Committee and ACR Board nominees at the annual meeting in November. The Committee on Ethics and Conflict of Interest presented a draft of a conflict of interest policy for the editor of the new publication, which was approved after some modification. This committee also presented a draft of revisions to the disciplinary policy, which was approved. The REF, the Committee on Corporate Relations, the Committee on Journal Publications and the Finance Committee also reported to the Board.
Following the formal board meeting, a subgroup of board members and committee chairs met with past president Ron Kaufman, MD, MBA and Tiffany Schmidt, JD, MBA, Vice President of Socioeconomic Affairs for the ACR, to review and critique the recently proposed Medicare Physician Payment Reform and Quality Improvement Act of 2006. The ACR plans to provide congress with its comments on this bill, which links significant improvements in the Medicare reimbursement formula to quality of care initiatives.
Best wishes for a relaxing summer. I'll look forward to seeing many of you at the Annual Meeting in November.
Sincerely,
Mary K. Crow, MD
President, American College of Rheumatology
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