Rheumatology Practice Management October 2018 Vol 6 No 5

The general theme of this issue of Rheumatology Practice Management (RPM) can be summed up in one word: participation. Whether as individuals, or as part of a group, the more we are willing to participate in the world around us, the more positive outcomes we can generate for our patients and our practices.
Although the National Organization of Rheumatology Managers (NORM) is always here to be a strong voice for our members, your independent voice is just as important. People often feel that the efforts of a large group are more effective than the efforts of individuals when it comes to fighting for an issue, but the truth is that our state and federal representatives want and need to hear from you. In addition, insurance companies want to know just how many people are affected by a particular issue, such as a change in billing policy. These people and organizations need to understand why you, as an individual, feel that the fight is important.
It is no secret that the healthcare industry loves acronyms. Most of us probably speak these acronyms in our sleep. Understanding and navigating through this “alphabet soup” is one of the many challenges that managers face in rheumatology practices across the country. The National Organization of Rheumatology Managers (NORM) has a plethora of resources available for its members through the NORM Education Committee (NEC).
Trust is a key ingredient of teamwork, and the best thing about trust is that it is contagious. Let’s look briefly at how the principles of teamwork come into play in one of my favorite pastimes, and how these same principles can also translate to your medical practice. Then, I will explain how the Forté Communication Style Profile assessment can increase trust and collaboration in your office.
The National Organization of Rheumatology Managers (NORM) is pleased to give readers the opportunity to learn more about another one of our members, Hana Ali, MBBS. Hana is a trained physician who made a conscious decision not to pursue a license to practice medicine. Instead, she chose to invest her time and talents into helping her husband grow an independent rheumatology practice. Fast forward 12 years, they now have a thriving practice and newly negotiated contracts with major insurances.
I have been in the rheumatology field for approximately 23 years, and I have seen many patients with rheumatoid arthritis (RA) come through my practice. As a rheumatology manager, I can sympathize with the various struggles they have, including concerns over the cost of their therapies. I would say I am a very compassionate person toward our patients.
The National Organization of Rheumatology Managers recently visited Tampa, FL. Not only does this city have the Tampa Bay Buccaneers National Football League team, they also celebrate Tampa’s most famous pirate, José Gaspar, at the Gasparilla Festival. The parade to honor José Gaspar features pirates sailing into Tampa Bay and coming ashore to demand the keys to the city from the mayor.
The Centers for Medicare & Medicaid Services (CMS) has published numerous articles notifying Medicare providers and suppliers that they cannot bill beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program for Medicare cost-sharing. QMBs have Medicare as their primary insurance and Medicaid as their secondary insurance. Medicare beneficiaries enrolled in the QMB program are not legally obligated to pay the deductibles, coinsurance, or copays for any Medicare-covered items or services. In addition, a state may or may not pay the deductible or coinsurance for the QMBs it insures, depending on its Medicaid program; most states do not.
Researchers evaluating the cost benefits of biosimilars for the treatment of patients with rheumatoid arthritis found that the yearly annual prescription cost of the biosimilar, infliximab-dyyb, was 18% less than that of the brand name biologic, infliximab.
“Minimizing the daily steroid use of systemic lupus erythematosus patients while concomitantly controlling their disease activity may reduce the looming economic burden associated with corticosteroid use,” said Shaum Kabadi, PhD, and colleagues.
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