State of the Industry Report: Rheumatology

The leading cause of disability among adults in the United States is arthritis 

Arthritis currently affects more than 50 million Americans, according to the Arthritis Foundation and nearly 300,000 babies and children are also said to be living with arthritis or a rheumatic condition and almost two-thirds of adults in the U.S. living with arthritis are of working age (18-64 years).1

Osteoarthritis, which affects an estimated 31 million Americans annually is the most common type of the condition, which is most common in general among patients who are also living with other chronic comorbid conditions, including heart disease (49 percent of adults with heart disease also have arthritis), diabetes (47 percent), and obesity (31 percent).1 More common in women than in men, arthritis, as well as other non-traumatic joint disorders, is estimated to be among the five most costly conditions among adults 18 and older in the U.S. today, with the number of people expected to a physician-confirmed diagnosis reaching 78 million by the year 2040.1

Will these patients have access to optimal care as defined by clinical best practices and be able to find a provider who can accept new patients for a growing patient caseload? Currently, the outlook is quite painful in that regard. This resource guide will share some current workforce projections for this specialty, offer resources for current providers to consider clinical best practices, and provide information on current trends in practice and clinical care.  

Workforce Study Results

As of 2015, the number of adult workforce providers who are employed as rheumatology specialists, defined as either physicians, nurse practitioners (NPs), or physician assistants (PAs), was totaled to be just more than estimated 6,000 people in the U.S. Research conducted by the American College of Rheumatology (ACR) for its Workforce Study has found that this figure represents an already inadequate amount of available caregivers based on demand. Projections for working specialists by the year 2030 cite a decrease to fewer than 5,000 providers, which would represent a 25.2% decrease in supply, while demand is projected to exceed supply by 4,133 clinical full-time equivalent clinicians by a rate of 102%.2 

According to the study’s authors, the projections for this workforce reflect a “major demographic and geographic shift that will significantly impact the supply of the future workforce by 2030.” The significance of baby boomer-aged professionals retiring combined with a predominance of the millennial-aged population and an increase of part-time providers is responsible for the perceived shift, which would parallel with an increased demand for rheumatology care due to the growing and aging U.S. population, the report claims. Officials with the ACR are calling for regional and innovative strategies to help to manage access to care while reducing barriers to care for rheumatology patients, including for the recruitment of fellows, NPs, and PAs to address the anticipated workforce gap and processes to retain providers who can facilitate access to quality care. 

Providers Invited to Review Rheumatology Best Practices Guidelines

Individual healthcare providers and their organizations are invited to review and provide follow-up comments on the guidelines for quality care quality offered by the ACR. According to ACR officials, clinical practice guidelines are developed to reduce inappropriate care, minimize geographic variations in practice patterns, and enable effective use of healthcare resources. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.3 

Current available guidelines include those related to axial spondyloarthritis, extrarenal lupus, glucocorticoid-induced osteoporosis, gout, juvenile idiopathic arthritis, lupus nephritis, lyme disease, osteoarthritis, perioperative management, polymyalgia rheumatica, psoriatic arthritis, reproductive health involved with rheumatic disease, rheumatoid arthritis, and vasculitis. Providers who would like to review and potentially provide feedback on the recently listed guidelines online can visit

Insurance Coverage Does Not Always Help Rheumatology Patients

People who live with rheumatic disease are known to have difficulty affording their treatment, and state-by-state variations may be partly culpable. The ACR’s 2019 Rheumatic Disease Patient Survey has provided some insight into related challenges that impact patients’ daily life and healthcare.

The online survey polled more than 1,500 patients aged 18 years and older and asked a range of questions related to healthcare access, affordability, and lifestyle. According to the findings, 90 percent of people have health insurance, but 60 percent have experienced difficulty in the past year with affording their medications or treatments. About 25 percent of patents reported out-of-pocket treatment costs of more than $1,000 annually and 6 percent of patients reported their costs to be more than $5,000 per year. From a quality-of-life standpoint, nearly two-thirds of patients reported that performing everyday tasks such as cooking, eating, dressing and running errands were limited by their disease.

FAST FACT: The Centers for Disease Control and Prevention reports that one in four people living in the U.S. has a rheumatic disease.

Rheumatic Patients Can Consider Family Planning 

The challenges associated with rheumatic illnesses and the likely comorbidities may warrant family planning for many women. According to research, family planning methods may help optimize pregnancy outcomes in patients or help them avoid pregnancies, if desired.4


  1. Arthritis Facts. Arthritis Foundation. 2018. Accessed online:
  2. Battafarano DF, Ditmyer M, Bolster MB et al. 2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015–2030. Arthritis Care and Research. 2018.
  3. Clinical Practice Guidelines. ACR. 2019. Accessed online:
  4. Rodriquez T. Family Planning Essential for Women With Rheumatic Diseases. Rheumatology Advisor. 2019. Accessed online:

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