Demographics and financial impact of home respiratory care.

Healthcare policymakers, governmental and private alike, are now faced with an enormous challenge. Demands for improved access to cost-effective and high quality healthcare are emanating from all segments of our society. Clearly, the traditional model of admitting patients to an acute care hospital as a first-line intervention is losing favor. Although there will always be a role for acute hospital care, utilization of this high-cost setting must be better managed if runaway healthcare costs are to be brought under control. The concept of moving patients along the healthcare continuum as their response to treatment reduces the acuteness of their condition is rapidly gaining support, especially with third-party payors. Accordingly, home healthcare providers, including those offering respiratory home care services, can expect to see an increase in the number of referrals they receive. HME/RT providers must actively promote the benefits they can offer in terms of high quality, cost-effective outcome. It is not unrealistic to suggest that the savings realized by reducing an acute hospital stay by 1 day can easily cover the costs of providing respiratory home care for 4 to 6 weeks. One can only hope that such compelling arguments, occurring at a time when healthcare reform and restructuring is a national priority, will translate to more equitable reimbursement guidelines for respiratory home care providers. The past practice of only reimbursing for equipment and supplies fails to take into account the vital role played by the home respiratory therapist. Home respiratory equipment and supplies, while an important component of managing chronic respiratory disease, are only effective if used safely, properly, and in compliance with the prescribing physician's intentions. The use of skilled and dedicated home respiratory therapists to train patients, monitor and assess outcomes, and communicate with the prescribing physician ensures optimum results. It is time for reimbursement policies to recognize this vital role played by home respiratory therapists.