Arthritis Care, Treatments And How To Save

This guide is focused on helping you understand your risk, get better outcomes, and find ways to secure more affordable care.

What Arthritis?

Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods.

With all of the different kinds of prescriptions, treatments and therapies that exist for arthritis, it can become a difficult condition to manage and afford. Luckily, there are plenty of ways you can save on treatment so you can focus more on what matters.

Most Common Types of Arthritis

• Osteoarthritis
• Rheumatoid arthritis
• Psoriatic arthritis
• Fibromyalgia
• Gout

Where To Start: Finding The Right Provider

Start With A Visit To Your General Practitioner

It’s always best to start with a general practitioner (GP). Trying to find a specialist on your own is possible, but it’s a process that usually feels like you’re playing Where’s Waldo. The sea of names, practices and groups can be daunting.

Your GP or primary care physicians (PCP) are gatekeepers to the medical community. They’re the first to diagnose your condition and provide you with a broader perspective based on your personal medical history. The more they know about you, the more effective they’ll be at diagnosing your symptoms and recommending the right next course of action. They are the ones who make your referrals to specialists they know and trust.

Using Doctor Review Sites and Cost Estimator Sites To Find A Rheumatologist

There are many things to consider when it comes to finding the right specialist for your arthritis treatment. If you’re just starting the process the best way is to start with a recommendation from your GP.

Most of the time your GP will point you in the direction of a Rheumatologist for treating arthritis.

If you’re comparing a few different Rheumatologists, review sites, transparency sites and insurance cost estimator tools are a great way to understand where rheumatologists stack up in regards to overall price and how successful they are at helping patients achieve positive outcomes.

Top Doctor Review Sites For Rhuematologists

• Medicare.gov Doctor Compare
• Healthgrades
• Zocdoc
• US News & World Report
• The Leap Frog Group (for hospitals)

Cost Estimator Tools For Arthritis

Your insurance company might also provide cost information as well as patient satisfaction information. These are the resources you have access to if you’re insured by a major insurance company. Note, you will need to log in to your account to access the tool.

• United Health Care Cost Compare
• Cigna Cost Compare
• Anthem Cost Compare
• Humana Cost Compare
•  

If you aren't insured by a major carrier these tools also provide price transparency information:

• Healthcare Blue Book
• MD Save
• Guroo
• FairHealth Consumer
• Clearhealthcosts.com
• Medibid

When it comes to comparing costs, no one tool is always the best—it's a good rule of thumb to always check multiple tools.  The cost tools provided by your insurance provider will be the most accurate, but it's important to vet their discount prices versus the average.

Selecting The Right Rheumatologist For You

Beyond cost and reviews, what are the other factors you should consider?

• Find a rheumatologist with board certification
• Ask about clinical trials and recent research. You want to find a rheumatologist who is knowledgeable in the field.
• Ask how well your physician is connected to the rheumatology community?

Start With This Checklist Of Questions

• Are they easy to access?
• What is the quality of their care?
• What do they charge?
• Are they in your network or out of it?
• Are they board certified?
• Do they have experience managing your condition(s)?
• How long have they been in business?
• Are they taking new patients?
• What is their hospital affiliation?
• Are there any red flags such as malpractice suits or sanctions?
• Are they vested in technology?
• Do they participate in electronic medical records and coordinate electronically with pharmacists, other specialists, hospitals, and you?

One of the things you want to focus on how well you and your doctor get along. You want a specialist who respects your opinion and is open to creating a long term relationship. They should not only be interested in helping your health, but also in making sure they care about helping you navigate the healthcare system in the best way possible.

Beyond that there are a few specific things you should consider. It’s important to interview a few doctors first before you seal the deal.

Area of Specialty in Rheumatology

Rheumatology is already a medical specialty, but many rheumatologists specialize in treating specific diseases, such as rheumatoid arthritis or lupus. Ask around to find a rheumatologist who specializes in rheumatoid arthritis and is well equipped to treat your condition.

Always Look For Practices With Patient Support Systems

Lifestyle changes are usually on the list of things to consider with Arthritis. One thing you should consider when you're comparing specialists is whether or not their practice offers patient support systems. Patient support systems provide help outside of the office for things like physical therapy and weight management programs, which can be incredibly helpful for managing the symptoms of arthritis.

The biggest benefit they offer is keeping you on track with your treatment plan. They're your advocate in the system who help you get better, faster.

These services are offered at no extra cost to the patient and are usually referred to as a number of different names, that all do the same thing. When you’re researching rheumatologists, look for:

• Health navigators
• Care navigators
• Patient navigators
• Care managers
• Chronic disease management programs

The Doctor’s Communication skills

Make sure your rheumatologist is a good communicator who seeks your input, asks probing questions and answers your call (or calls you back) when you need help or information. Ask yourself this: Does the rheumatologist answer my questions and explain complex medical issues clearly, so I can understand them?

The Practice’s EHR (Electronic Health Record) System

What’s an EHR? EHR stands for electronic health records. Back in 2009, the federal government passed a law called HITECH (the Health Information Technology for Economic and Clinical Health), which basically mandated that doctors start to use electronic health record systems.

About 80% of physicians now use a “certified EHR”. EHR’s allow doctors on the same system to easily and instantly share charts, notes and your medical history. Finding a specialist that’s on your hospital and GP’s EHR will make communication between doctors a whole lot easier.

Ask the specialist’s practice which EHR they use and then cross compare that to the doctors you’ve already established a relationship with. Here’s a list of the most popular EHRs:

• Allscripts
• Cerner corporation
• Epic systems
• eClinicalWorks
• CareCloud
• GE Centricity
• NextGen

Is it essential that your doctors are on the same EHR? No. But it will make your quality of life, and the doctor’s ability to communicate easier.

Alliances with Other Specialists

Rheumatologists often need to refer people to another healthcare provider, such as a gastroenterologist, pulmonologist or physical therapist. Ask your rheumatologist about their ties to other medical professionals and what hospital(s) they’re affiliated with.

RA research knowledge

A good rheumatologist will be on top of all the latest research and developments in RA. They should also be well informed about clinical trials being done on RA meds, in case you’re eligible to participate in a study. 

Whether They’re A Solo Practice or Multi-Physician Practice

A multi-physician practice will have better coverage or physician availability for patients if there is an urgent need. Though, if your disease is well maintained, this may not be as important of a consideration when choosing a Dr. 

What To Expect From A Visit With A Rheumatologist

How to Prepare For An Effective Visit

Rheumatologists are experts in the most common arthritic diseases and also focus on diagnosing autoimmune diseases that affect the skeletal system.

Most Rheumatologists are outpatient providers which means there are a few things you need to consider before choosing a practice to visit.

• Is it in network?
• Do they offer discounts?

How To Talk To Your Doctor

While most of us are used to relying on our doctor’s to guide the conversation, the only way to make sure you’re getting the best care is to speak up. Most doctors and practices are trained in the SBAR method. Use it to organize your thoughts.

• Situation: take ten seconds to explain your ailment
• Background: provide context with your medical health record
• Assessment: describe the specific problem/situation
• Recommendation: explain what you want to do about it and when

How Arthritis is Diagnosed and What to Expect

There are more than one hundred variations of arthritis, meaning the exact diagnostic procedure can vary on a case by case basis. However, the initial steps should follow the same procedure an escalate to the next procedure based on similar findings.

It’s important to understand this process and why each step is being taken. Remember that you have the power to gut check a particular test based on your level of symptoms.

1. Your Rheumatologist Will Ask About Family and health history
   You rheumatologist should start with questions about your symptoms, health habits and family history.
2. Every Diagnosis Then Moves To A Physical Exam
   Most arthritis causes visible swelling in the joint. Your rheumatologist should conduct an extensive exam comparing joints on one side of the body to the other, if there is fluid buildup in the joint, pain and range of motion of the joint and other physical exams.
3. Your doctor might order additional tests
   The most common tests are blood tests, imaging tests, and lab tests of fluids called arthrocentesis. These tests are usually taken one after the other if the last test didn’t lead to a conclusive diagnosis. The most common form of arthritis is Osteoarthritis, so in many cases a full battery of tests probably won’t be necessary. However, if the condition is more severe, then more tests are necessary.

Questions to Ask Your Doctor Ask You Discuss The Diagnosis And Treatment Options

• What is the test for?
• How many times have you done this procedure? 
  
• When will I get the results? 
  
• Why do I need this treatment?
• Are there any alternatives?
• What are the possible complications?
• Which hospital is best for my needs?
• How do you spell the name of that drug?
• Are there any side effects?
• Will this medicine interact with medicines that I’m already taking?
• What is my diagnosis?
• What are my treatment options?
• What are the benefits of each option? What are the side effects?
• Will I need a test? What is the test for? What will the results tell me?
• What will the medicine you are prescribing do?
• How do I take it? Are there any side effects?
• Why do I need surgery? Are there other ways to treat my condition? How often do you perform this surgery?
• Do I need to change my daily routine?

How to Save On Diagnostic Testing For Arthritis

If you have health insurance make sure staying in network. As a general rule of thumb, a free-standing lab that specializes in imaging will be less expensive than getting an X-Ray or MRI at a hospital.

Tools to find a free standing imaging clinic:

• LabFinder
• ACR Accredited Facility Search

Average costs for self-pay arthritis diagnostic procedures according to LabFinder

Arthritis screening panel	$80
Rheumatoid Arthritis Factor Panel	$15

If you don’t have insurance, or haven’t met your deductible yet, these other tactics are a great way to lower the cost of your exam:

• Ask for the cash-pay price; you might receive a discount of up to 30% if you can pay upfront
• Ask if the facility offers a payment plan
• See if the facility provides any assistance programs 

Treating Arthritis

Common Treatment Options And Drug Classes For Arthritis

• Biologics: used to prevent inflammation by stopping particular molecules in your body that usually cause inflation.
• Analgesics: these are pain reliving drugs, the most common being acetaminophen and NSAIDs but analgesics can also include opioids.
• Corticosteroids: usually referred to as just "steroids", corticosteroids mimic cortisol and reduce swelling and inflammation. 
• DMARDs: also work to protect joints by decreasing pain and inflammation, but do so over a longer period of time
• NSAIDs: the most common type of pain reliever in the world, found in ibuprofen.

What To Ask Your Doctor About Your Medication

• Do I need medication, or are there other ways I can control my Acid Reflux?
• If I do need medication, what kind?
• Will an over-the-counter remedy work for me?
• What side effects can I expect?
• When is the best time of day to take the medication? And how often?
• How long do I need to remain on this medication if my arthritis improves?
• What alarm symptoms should I watch out for as I start this treatment?

Common Prescription Treatments For Arthritis And How Much They Cost

Saving On Prescription Drugs

Whether your health insurance covers prescription medication or you have to pay out of pocket, drug cards are one of the most effective way to save on Rx. See our how drug cards on our How to Save page.

Drug cards aren't the only way you can save on prescriptions, though. There are tons of insider tricks you can follow, starting with asking your doctor the right questions. See our guide to the questions you should be asking to save money on your prescriptions.

Surgery For Arthritis

In severe cases, surgery might be required to replace an arthritic joint. Knee replacements and hip replacements are the most common surgeries done for arthritis.

Here’s what you should know and how to save on surgery for arthritis:

The Cost of Common Arthritis Surgeries Across The US according to Guroo.

Surgical Procedure	Average Cost
Hip Replacement	$36,244
Knee Replacement	$36,206

The cost estimator tools listed earlier provide pricing information based on your location so you can see how much a procedure costs where you live compared to nearby cities.Traveling for surgery can also be an option to look into—especially if you live in a region where the cost of healthcare is heavily inflated.

Lifestyle Changes That Will Improve Your Health

Changing Your Lifestyle to Help Cope with Symptoms and Increase Your Health

Sometimes the easiest way to lower the cost of healthcare is simply not to get sick. With most cases of Arthritis, that isn’t totally a reality, but there are tons of small lifestyle changes you can make to help manage your symptoms.

One of the major culprits is diet. A vegetable rich diet on top of plenty of Omega-3s is a great, manageable way to reduce inflammation in your body.

Another tip is to keep moving and avoid holding one position for too long.

The Mayo Clinic and the Arthritis Foundation have great resources and guides for lifestyle changes that can help you manage your symptoms.

Living With A Chronic Condition

Living with a chronic condition can be incredibly difficult. Arthritis especially adds pain, discomfort, and stress to your life. But when it comes to receiving care and being able to afford the cost of care, you have many more options than you think.

We continually update this guide with the latest tools, resources and savings tips. If you have a story to share about your treatment or how you’ve Uncovered better healthcare, join our community and share it!