OBJECTIVES: In 2005, a quality measure was added to the Healthcare Effectiveness Data and Information Set (HEDIS) that quantifies the proportion of rheumatoid arthritis (RA) patients who receive disease modifying anti-rheumatic drug (DMARD) therapy in a given year. This study describes annual trends in the HEDIS RA management quality measure among commercially- and Medicare supplemental-insured U.S. RA patients from 2005 to 2012. METHODS: This was a retrospective observational study based on U.S. administrative claims data. Patients selected for study during a given measurement year were aged ≥18 years, had continuous insurance enrollment throughout the year, and had two outpatient claims, on different days, with a diagnosis of RA (ICD-9-CM codes 714.0, 714.1, 714.2, 714.81). Receipt of a biologic or non-biologic DMARD therapy was assessed annually from 2005 to 2012. Bivariate statistics were used to test for differences across the years. RESULTS: Annual sample sizes averaged ~95,000 RA patients. From 2005 to 2012, the RA quality measure was stable at approximately 83% of RA patients receiving DMARD treatment. Biologic DMARD utilization increased from 32% in 2005 to 39% in 2012 (p<0.001), whereas use of non-biologic DMARDs decreased slightly from 74% to 72% (p<0.001). Among the subset of patients aged ≥65 years with Medicare Supplemental insurance, the RA quality measure was slightly lower at approximately 78% receiving DMARD therapy. Fewer RA patients with Medicare Supplemental insurance received biologic DMARDs, however, utilization increased from 23% in 2005 to 29% in 2012 (p<0.001). In the same time period, non-biologic DMARD use decreased from 73% to 69% (p<0.001). CONCLUSIONS: Since the 2005 introduction of the HEDIS RA management quality measure, increases in the use of biologic DMARD therapy were offset by decreases in the use of non-biologic DMARD therapy. Findings suggest potential room for improvement in the quality of care for RA patients.