Pulmonary rehabilitation (PR) teaches individuals with COPD how to manage their disease while helping them to increase their self-confidence and physical endurance through exercise.
“Pulmonary rehabilitation is a behavior modification intervention that requires the patient to be motivated and actively engaged in the process,” Trina M. Limberg, RRT, FAARC, FAACVPR, says.
PR uses a complete approach to treatment that involves physical training and selfmanagement education. It helps reduce symptoms in patients by reducing breathlessness and increasing exercise tolerance while also reducing the number of hospital stays.
Patients and caregivers can greatly benefit from the education, exercise training, breathing retraining, nutrition counseling and emotional support.
In 2011, the Centers on Medicare and Medicaid (CMS) released, “2012 Rules for Hospital Outpatient Prospective Payment”—which became effective in January of this year. It reported that the payment rate for PR services dropped by 40 percent —from $63 to $37 per session.
The new rules and reduced payments threaten the viability of PR centers across the country and downplay the needs of the COPD community. Although changes cannot be made for 2012, pulmonary organizations are pooling their efforts to prevent a downward trend in 2013.
Limberg believes a collaborative effort among professional pulmonary organizations is the key to helping PR centers survive.
“Our services make us valuable partners for transitioning patients home and keeping them out of emergency rooms,” Limberg says. “?is is the best area to develop services in collaboration with acute respiratory therapists, nurse case managers, durable medical equipment companies and out-patient physician groups.”
The COPD Foundation supports this collaboration through its Pulmonary Education Program (PEP), a project that provides educational materials for PR centers and their staff, free of charge. PEP ensures that individuals with COPD receive ongoing support, resources and the necessary tools to promote long-term benefits a?er rehabilitation.
PEP provides educational resources to PR center staff and informational welcome packets to every patient enrolled. Upon completion, patients receive PEP Graduation packets that contain resources designed to help them remain successful in their efforts at self-management of their COPD.
Limberg says that overall, PR is a “severely underutilized service that can improve the quality of life and reduce care costs.”
“It truly is amazing that it [PR] is a standard of care and yet rarely ordered for patients who can benefit [from it]. It is clear that increased education about the benefits of pulmonary rehabilitation is much needed,” Limberg says. “I hope to one day retire and not hear this all too frequently asked question, ‘Why didn’t my doctor refer me sooner?”
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