Position Statement: Access to Medical Care for Patients with Respiratory Disease

The American College of Chest Physicians supports the passage of the Medicare Respiratory Initiative - HR 3968 introduced by Congressman Mike Ross (D-AR). The focus of this legislation is to increase access to medical care for patients with significant respiratory disease, which will serve to reduce hospital admissions, lower healthcare expenses, and offer these patients a better quality of life.

Respiratory therapists are credentialed licensed professionals who have the requisite training to care for patients who may not have the ability to personally see a physician regularly for their respiratory health care needs. HR 3968 provides patients with a level of care previously not available because of the lack of reimbursement for respiratory care services rendered. Making this pathway to care available to patients also addresses the need to foster mechanisms for qualified allied health care professionals to assist in patient care to mitigate the growing crisis in the pulmonary and critical care physician workforce.

The legislation proposes to revise the Medicare statute to permit qualified respiratory therapists, with an RRT and bachelor's degree, to furnish respiratory therapy services without the physician being physically present at the time the service is rendered. This means flexibility for the physician and new opportunities to provide appropriate levels of care outside of the hospital setting. Under general supervision, a qualified respiratory therapist would be able care for patients by providing asthma education, smoking cessation services, and educating patients regarding the appropriate use of medications while the physician is providing patient care at the hospital. The practical application of HR 3968 would also allow for extending ventilator home care to more patients, increasing the safety of home mechanical ventilation, lower overall healthcare cost, and ensure accurate and informed drug use by patients outside of the acute care hospital environment.

There has been significant change in the delivery of health care services since the Medicare statute was first enacted. Services that once could only be provided in an acute hospital setting are now being delivered in alternate care sites. This is especially true for pulmonary medicine and respiratory therapy services. Medical evidence supports the efficacy of services delivered by qualified respiratory therapists. Under current law, this option is not available; therefore the ACCP supports HR 3968, The Medicare Respiratory Initiative.