2022 Rheumatic Disease Report Card

The American College of Rheumatology (ACR) recently published its 2022 Rheumatic Disease Report Card, which examines how easily a person with a rheumatic disease can live well in the United States. The goal of the report is to inform and motivate policymakers and the public to address healthcare access, affordability, and lifestyle factors that impact quality of life for these patients. 

​​They graded every state regarding the quality of life for Americans living with a rheumatic disease.

For numeric indicators – the number of people per rheumatologist, the percent of residents who do not have health insurance coverage, the prevalence of arthritis-attributable activity limitations among adults, and the percent of adults who are physically inactive – the maximum number of points were awarded to states that ranked in the top quintile, while states ranking in the second quintile received 4/5 the maximum number of points, and so on.

And for the indicators tracking state legislation prohibiting specialty tiers and copay accumulators, points were awarded on an all-or-nothing basis. For other indicators tracking state legislation – step therapy, prior authorization, and pharmacy benefit manager (PBM) regulations – as well as the presence of CDC-funded activity programs, states were awarded partial credit for meeting some criteria. States were then awarded a letter grade (A, B, C, D, or F) in each category based on how many points they earned, as well as an overall grade consisting of the average score between the three categories.

The net net? Across the country, improvements very much are needed to increase the quality of life for people living with rheumatic diseases. Out of the 50 states and the District of Columbia, no state scored an A, and only two states improved their 2018 grades. The highest scoring states were New York, Virginia, Maryland, California, Illinois, and Louisiana. The lowest performing were Wyoming, Nevada, South Carolina, Mississippi, Idaho, and Alabama.