CQRC members provide patient-centered care in the home to individuals who require home oxygen, home sleep, and home non-invasive ventilation therapies. During the pandemic, CQRC members expanded access to these home therapies to enable more beneficiaries to receive their care at home instead of in the hospital. As the country moves beyond the pandemic, the CQRC has prioritized protecting continued access to individuals who continue to need these therapies by strengthening the Medicare benefit.
What is Home Respiratory Therapy?
Home respiratory therapies (RT) are sometimes necessary to help patients breathe. After a doctor determines that an individual requires respiratory therapy—but does not need to be admitted to a hospital or nursing home—a home respiratory provider will deliver, set up, and monitor the appropriate device to meet the patient’s unique medical needs.
Home respiratory therapy covers a range of safe, effective, and convenient devices including: home oxygen therapy, such as liquid oxygen and oxygen concentrators
home sleep therapy, such as Continuous Airway Pressure (CPAP) or Bi-Level (BiPAP) devices, and home ventilation devices, such as non-invasive ventilation (NIV)
In addition, home respiratory care providers help empower patients and their families by providing comprehensive education about managing their disease and the home respiratory equipment. They also work to improve patient outcomes by regularly visiting patient homes to conduct safety evaluations and ensure equipment is functioning properly and is being used correctly.
Regardless of the services a patient requires, home respiratory therapy is critical because it improves patients’ quality of life and allows them to experience greater independence in the comfort of their own homes.
Who Needs RT?
Home respiratory therapy is a lifesaving necessity for more than one million Americans.
Different respiratory patients will have different needs, which will help their doctors determine the most appropriate form of treatment. For instance, some patients may struggle to breathe on their own because they have a serious lung disease such as chronic obstructive pulmonary disease (COPD), others may experience blocked airways when they lie down to sleep (obstructive sleep apnea), and still, others may be living with neuromuscular diseases like amyotrophic lateral sclerosis (ALS) that make it increasingly difficult to respirate.
Other diseases that may require the use of home respiratory therapy include emphysema, congestive heart failure, bronchitis, lung cancer, and pneumonia.
Home Oxygen Therapy
Physicians prescribe home oxygen therapy for people who have lung or heart problems that may not get enough oxygen from the air around them. When a person does not get enough oxygen, he/she may experience difficulty breathing, fatigue, memory loss, headaches, and/or confusion. Supplemental oxygen helps these individuals get the oxygen they need. Home oxygen therapy is especially beneficial for patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD), the 4th leading cause of death in the United States, affecting more than 15 million Americans.
Home Ventilation Therapy
Physicians prescribe home ventilation for patients with acute or chronic respiratory failure, as well as those with neuromuscular diseases, including amyotrophic lateral sclerosis (ALS). Ventilators can be used invasively or non-invasively. Invasive ventilation delivers ventilation through a tracheostomy and may be used 24 hours a day or less.
Non-invasive ventilation (NIV) assistance delivers ventilation through a mask or mouthpiece connected to a ventilator to provide ventilation support during sleep or intermittently throughout the day. NIV provides the lung muscles with a chance to rest and improves breathing during the day.
Home Sleep Therapy
Physicians prescribe home sleep therapy for individuals living with Obstructive Sleep Apnea (OSA). This sleep disorder occurs when the airway is blocked or obstructed, resulting in no air moving into or out of the lungs. OSA may be due to various factors. OSA reduces the oxygen content in the blood and increases carbon dioxide levels. This can cause an increase in blood pressure, loss of restful healthy sleep, and daytime fatigue. Individuals requiring home sleep therapy will receive a Continuous Airway Pressure (CPAP) or Bi-Level (BiPAP) device which provides low-pressure airflow to a person’s airways, holding them open.
The Value of Respiratory Therapy
More than 1.5 million Americans depend upon home respiratory therapy to maintain a high quality of life while receiving the health care treatments they need in the setting they prefer.
Consider the use of home oxygen to treat Chronic Obstructive Pulmonary Disease (COPD). COPD affects more than 15 million Americans and is the country’s fourth-leading cause of death, according to the Centers for Disease Control and Prevention (CDC). Over six million Medicare beneficiaries (approximately 11% of all individuals enrolled in Medicare fee for service or Medicare Advantage) are living with COPD, making it one of the top 10 chronic conditions among Medicare beneficiaries.
If not managed appropriately, COPD leads to emergency room visits and hospitalizations. COPD is the primary cause of over 10 million physician office visits, 1.5 million emergency department visits, and nearly 700,000 hospitalizations annually.
Home oxygen provides individuals living with COPD the opportunity to remain in their communities rather than move to institutional settings for their care. Not only does it enhance their independence, but it also improves their health outcomes and helps prevent costly complications, ensuring that health care dollars are used efficiently—especially through the Medicare program.
Beyond COPD, home respiratory therapies such as home sleep and home ventilation therapies provide similar benefits to patients living with Obstructive Sleep Apnea (OSA), acute respiratory failure, and neuromuscular diseases.
Data show home respiratory services lower Medicare costs for respiratory care patients by providing a critical alternative to hospitalizations. CQRC members help patients manage their diseases and distinguish themselves among suppliers by providing subclinical services to patients to ensure that they remain compliant with their prescribed therapy and medications.