Casavant: Access to virtual care at risk for millions of arthritis patients

Arthritis is often simplified as joint pain or disease. While accurate, this barely conveys the real-life, lasting effect on 60 million adults and hundreds of thousands of children living with a form of arthritis.  

Symptoms — swelling, pain, stiffness and diminished range of motion — can vary from mild to severe, making everyday tasks painful and challenging. For many people, seeking regular treatment and visiting specialists in person is painful, difficult or even impossible. This underscores the urgent need for accessible telehealth options for patients living with one or more of the 100-plus forms of arthritis.

During the pandemic, expanded telehealth access for millions of patients, including many with arthritis, alleviated the burdens of in-person care and significantly increased access. Patients could attend appointments from the comfort of their homes, improving patient comfort and privacy, eliminating the need for travel, reducing exposure to viruses — particularly important for patients with autoimmune arthritis, cost savings of transportation or parking expenses, and creating a direct line to experts with the click of a button. Given the significant shortage of arthritis specialists, this benefit cannot be overstated.  

Unfortunately, the telehealth flexibilities granted during the pandemic, which provided waivers for Medicare beneficiaries to receive treatment virtually, are set to expire at the end of this year. The result has left lawmakers clamoring for legislation safeguarding telehealth access and several hearings and markups on the topic. Administration officials are also working to maintain telehealth flexibilities in the recent Centers for Medicare and Medicaid Services Physician Fee Schedule.

While arthritis also affects younger patients, nearly half of U.S. adults 65 or older are living with arthritis. This access has been critical for many patients to receive valuable treatment. More than 50 million Medicare beneficiaries received treatment via telehealth in 2020, and it remains a relied-on and utilized form of care. 

According to a study from the University of Rochester and Rochester Regional Health, nearly three-quarters of rheumatoid arthritis patients reported a positive overall impression of telehealth care. Jerry Zimmerman, a telehealth arthritis patient, shares his perspective: “The technology is very good. (My doctor) can do as thorough an exam as if she is right there in the room with me.”

The National Institutes of Health reported telehealth to be beneficial for arthritis management. It said, “It is also beyond doubt that telehealth will be part of the solution in future rheumatology care.” 

With a chronic condition comes the worry of missing appointments due to pain. Telehealth alleviates roadblocks and makes access to specialists closer than ever, including for families with a child living with juvenile arthritis. Eight states have no pediatric rheumatologist at all, and six states have only one. Closing geographic accessibility gaps not only increases access to specialists but also decreases travel time and time that patients or caretakers are required to take off from work.

More than 80 percent of patients surveyed by the Arthritis Foundation reported their virtual visit was more effective because they did not have to commute to the appointment. This is an essential  aspect of virtual care for arthritis patients in rural or underserved areas who may have to travel for hours or to a neighboring state to meet a provider who can attend to their needs. Telehealth can also reduce the need for clinical visits for arthritis patients by almost 70 percent.

As experts have stated, “Telehealth has and will continue to play a role in access for patients. Whether due to geographic or time barriers, telehealth options provide patients a quick and efficient opportunity to check in with providers and ask questions. It is also a comfortable and flexible option for both patients and providers, and although telehealth may not be appropriate for all arthritis-related appointments, it increases access opportunities.”

Unortunately, there is no cure for arthritis. Thankfully, telehealth can make living with a chronic health condition more manageable. The Arthritis Foundation has designated the expansion of telehealth as a priority goal in improving the health of patients living with chronic conditions, including arthritis. Our advocacy initiative, the Ideal Model of Care, outlines solutions to many challenges arthritis patients encounter and the fundamental role of telehealth in achieving quality healthcare.

Solutions such as physical therapy, care coordination over your lifetime and timely access to providers are essential aspects of arthritis care and are strengthened through telehealth. Most patients living with arthritis also have other chronic or comorbid conditions. They report regularly seeing three to 14 healthcare providers, including two or three for their arthritis alone. Families with a child living with juvenile arthritis report seeing upward of 25 different providers.

Research has found that “having the ability to easily and directly connect with their providers should reduce patients’ avoidable hospital admissions or readmissions and ideally reduce the number of days they require inpatient care.”

There is overwhelming bipartisan support to safeguard patient access to telehealth without burdensome restrictions. This is crucial for those living with chronic diseases. We cannot afford to let the federal telehealth cliff occur. We must ensure that patients nationwide can continue to rely confidently on virtual care to manage their arthritis.

Editor’s note: Alisa Vidulich Casavant is the senior director of policy at the Arthritis Foundation. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.