1997 OPEN FORUM Abstracts
Experiences in Developing , Selling, and Managing a DME Company Based Asthma Education and Intervention Program
Joseph S. Lewarski, RRT, Hytech Homecare, Mentor, Ohio, Sunday, December 7, 1997.
Asthma affects an estimated 12 million Americans. Recent research suggests that asthma accounts for over 15 million physician office visits, 1.2 million emergency room visits, 500,000 hospitalizations, and over 10 million missed school days annually. The associated costs are astounding: $1.6 billion for hospitalizations; $295 million for emergency room visits; and $1 billion for medications. The National Institute of Health recommends that health care plans offer some type of formal asthma education to their clients, however, despite the growth of Health Maintenance Organizations, the idea of proactive healthcare management is still a relatively new concept for the insurance industry. The future of effective alternate site care is based around the development of innovative products and services that promote reduced utilization of acute care services. Strong respiratory based DME companies have the tools to create and market disease management products that fill this new healthcare need. The Hytech Homecare asthma education and intervention program uses DME based respiratory care practitioners to provide cost effective, in-home education and assessment with the following goals in mind: improve the patient/caregiver understanding of asthma; modify behavior to increase compliance to treatment regimens; improve the quality of life for patients with asthma; and reduce the cost of care associated with asthma. Using specially trained respiratory care practitioners, we go into the patient's home to perform a detailed clinical and environmental assessment, identify education needs and prepare an individualized education care plan and training schedule. Objective and subjective pre and post data collection tools are used to find areas of concern, we then focus us on those areas and then use those tools to measure success. Throughout this process we are in close contact with the insurance case manager and attending physician and upon completion of the program, detailed reports are sent to each. On-going utilization monitoring is achieved through a close relationship with the insurance company's utilization review team. Although conceptual in nature, we have successfully sold our disease management program to the managed care industry and find ourselves being paid for home respiratory services not directly linked to the rental or purchase of a piece of DME equipment.
AARC 50th Anniversary, December 6 - 9, 1997, New Orleans, Louisiana.