StratiHealth Launches Respiratory Patient Centered Care Services for Patients with Chronic Obstructive Pulmonary Disease (COPD) to Help Improve Outcomes and Reduce Cost

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The Use of Respiratory Therapists as case managers or physician extenders will improve health outcomes, reduce costs and help organizations to demonstrate meaningful use for patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD).

Pulmonary Horizons Program Committee

Vernon Pertelle, MBA, RRT

The Use of Respiratory Therapists as case managers or physician extenders will improve health outcomes, reduce costs and help organizations to demonstrate meaningful use for patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD).

Respiratory Patient Centered Care is designed to meet the complex needs of patients that are diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Respiratory Therapists (RTs) are key to the success of patient centered and disease focused programs. RTs will help to ensure we consider the whole patient and are centered on the patients' needs and preferences to ensure full engagement and compliance with their treatment plan.

A new approach to managing complex respiratory conditions is required in order to keep patients at a stable state in the low cost environment (their homes). RTs ensure that the health care team has a thorough understanding and knowledge regarding all components of respiratory modalities and technology used to treat patients. The "new normal" includes systems of care within Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs) that include Respiratory Therapists in managed and integrated care systems.

StratiHealth designs programs unique to your organization and provides Respiratory Therapists staffing and management. Effective communication between the healthcare team and patients requires the knowledge and expertise of a respiratory professional to ensure better health and financial outcomes. Care plans for COPD patients should be supported by evidence-based interventions and solutions tailored to the specific patient's needs and should be culturally appropriate.

The goals of Respiratory Patient Centered Care Services are to: (1) Improve the quality of care provided to patients with COPD; (2) Promote the use of a Respiratory Therapists in a COPD patient centered/disease-oriented approach; (3) Maintain a synchronous flow with the healthcare team for the wider objectives of COPD disease management (improved health outcomes, reduced cost); (4) Integrate Respiratory Therapists within health care organizations, Medical Groups, Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs) as physician extenders.

The Hospital Readmission Reduction Program (HRRP) is a reimbursement penalty approach for general acute care hospitals that have readmissions deemed “excessive” by CMS. Reduction is capped at 1% in 2013, 2% in 2014 and 3% in 2015 and beyond. Reductions apply to total DRG reimbursement. Penalties will be imposed on hospitals for readmissions deemed excessive for three specific conditions endorsed by the National Quality Foundation (NQF) including: Acute Myocardial Infarction; Heart failure and Pneumonia.

Centers for Medicare and Medicaid Services (CMS) is finalizing the expansion of the applicable conditions for FY 2015 to include patients admitted for an acute exacerbation of COPD. Thus it is absolutely essential for all organizations to develop and implement comprehensive services that include Respiratory Therapists throughout the continuum of care to mitigate the negative impact from penalties due to readmissions.

Said Vernon R. Pertelle, MBA, RRT, President and CEO, StratiHealth: "It makes perfect sense to utilize the allied health experts that are specialists in the care and treatment of patients with COPD." He added: "While serving as a respiratory case manager at a medical group with over 20 primary care physicians (PCPs) in 1998; we successfully improved outcomes and reduced the cost of care for patients with COPD." The services provided must include the whole patient and take into account early diagnosis and education to empower the patient, in addition to regular recurring home care visits [at least every two weeks or by exception] along with services in a chest clinic alongside PCPs and nurse practitioners.

Reducing the cost of health care and improving the patient's experience from services provided while assuring better patient outcomes is the goal of every health care organization and provider.

Our Registered Respiratory Therapists help assess and treat patients with COPD. Respiratory therapists assist with airway management, mechanical ventilation, disease management and case management of patients in their homes in collaboration with nurses and physicians and other members of the health care team.

The dynamics that exists today has created the need for network development and clinical programs that include respiratory therapists to improve health and financial outcomes. Organizations that are innovative and make the leap to include respiratory therapists in a more tangible and active manner will be poised for success.

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Vernon R. Pertelle
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