American Thoracic Society Statement: Optimizing Home Oxygen Therapy
By Gerene Bauldoff, PhD, RN, MAACVPR
In 2017, the American Thoracic Society convened a multidisciplinary workshop to develop recommendations to optimize home oxygen (O2) therapy. This panel included Chris Garvey, a well-known AACVPR pulmonary rehabilitation expert leader, and was organized to address increasing problems reported by patients and clinicians regarding home oxygen therapy.
As noted, more than 1.5 million Americans use supplemental oxygen. However, anecdotal reporting notes an “alarming frequency of implementation gaps in home oxygen” (p. 1370). These gaps include wrong or malfunctioning equipment, service delay, insufficient reimbursement and/or lack of follow-up monitoring. The issues are a combination of the advent of CMS competitive bidding for oxygen therapy services leading to necessary cost cutting by durable medical equipment companies. The end result has been a de facto
restriction on access to liquid oxygen (LOX) as well as decreased patients services that include education and in-home assessment and monitoring by respiratory therapists. Few patients are re-assessed for supplemental oxygen need after discharge, leading to patients having unnecessary oxygen in their homes. While additional documentation of beneficiary experience has been described by a partnership between the Centers for Medicare and Medicaid Services (CMS) and patient advocacy groups, compliance with existing standards remains low.
The workshop generated several key conclusions (p.1370):
- Oxygen users frequently experience significant and clinically unacceptable problems related to their oxygen equipment.
- Many healthcare providers that prescribe oxygen lack the resources and knowledge needed to prescribe oxygen delivery systems and devices.
- Patients with certain lung diseases and patients with higher oxygen needs are impacted to a greater degree than others.
- In the current healthcare climate, the services provided and business decisions made by DME companies constrain patients by restricting choices of stationary and portable oxygen equipment.
- Analysis is needed to quantify the unintended impact that the CMS competitive bidding policy has had on patients receiving supplemental oxygen from DME providers.
In conclusion, this important workshop has opened the conversation related to the current crisis in home oxygen therapy. Urgent attention and action is needed to address these critical issues.
The article is openly available in full-text and PDF at: https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201809-627WS
What does this mean for the PR Professional?
It is imperative that PR professionals be conversant in critical issues like those surrounding in-home oxygen therapy. With many PR patients being oxygen dependent, it is critical that we serve as vocal and knowledgeable advocates for our patients with other providers, durable medical equipment suppliers and those who generate or interpret the policies including. Part of our professional responsibility is to campaign for the most appropriate patient-specific oxygen delivery system, education and continued oxygen need assessment.
Reference: Jacobs SS, Lederer DJ, Garvey CM, Hernandez C, Lindell KO, McLaughlin S, et al. (2018). Optimizing home oxygen therapy: an official American Thoracic Society Workshop Report. Annals of the American Thoracic Society 15 (12): 1369-1381.
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