Home respiratory therapy provides critical medical services and cost-savings
to Medicare. For example, according to the COPD Foundation, Chronic Obstructive
Pulmonary Disease (COPD) affects more than 24 million Americans. CMS estimates
that 12 percent of Medicare fee for service beneficiaries are living with
COPD, making it one of the top 10 chronic conditions among Medicare beneficiaries;
dual-eligible beneficiaries are 1.7 times more likely to have COPD than
non-dual eligible beneficiaries. The Centers for Disease Control and Prevention
(CDC) estimate that COPD is the third leading cause of death in America,
claiming the lives of 134,676 Americans in 2010.
Home respiratory therapies – such as home oxygen, home sleep, and home
ventilation therapies – provide individuals living with COPD, Obstructive
Sleep Apnea (OSA), acute respiratory failure, and neuromuscular diseases,
the opportunity to remain in their communities rather than move to institutional
settings for their care. Research continues to show the benefits of home
respiratory therapy and its important role in our nation’s health care
system. Below are some examples of recent research supporting home respiratory
Dalal, F. Liu, & A. Riedel, “Cost trends among commercially insured
and Medicare Advantage-insured patients with chronic obstructive pulmonary
disease: 2006 through 2009,” Int J Chron Obstruct Pulmon Dis. 2011; 6:
533–542 (Oct. 2011).
- This study describes, among other things that home oxygen therapy is the
primary maintenance therapy for managing severe COPD.
- It finds that without such therapy, severe exacerbations can occur and
require hospitalization that can cost more than $14,000 (in 2009 dollars).
- “Treatments that reduce the frequency of COPD-related hospitalizations
or exacerbations are also associated with lower COPD-related medical costs,
and in some cases lower total COPD-related costs.”
COPD Foundation, “Impact of COPD on Health Care Costs” available
- In this report, the COPD Foundation estimates that 40 percent of COPD
costs could be avoided by preventing complications and hospitalizations.
J M Tuggey, P K Plant, M W Elliott , “Domiciliary non-invasive ventilation
for recurrent acidotic exacerbations of COPD: an economic analysis” 58
Thorax 867–871 (2003).
- This study describes how providing CPAP and BiPAP in the home reduces
hospital admissions and minimizes overall costs.
Kevin J. Potts, Dell T. Butterfield, Penny Sims, RN, Micah Henderson,
BS, Cary B. Shames, “Cost Savings Associated with an Education Campaign
on the Diagnosis and Management of Sleep-Disordered Breathing: A Retrospective,
Claims-Based US Study” 16 Popul Health Manag. 7-13 (2013).
- This recent study found that patients receiving positive airway pressure
therapy (PAP) have lower overall medical costs ($645.66 per patient per
month) and better health outcomes than those who did not ($846.58 per patient
Cai Q, Tan H, Singer J., Impact of Positive Airway Pressure among Obstructive
Sleep Apnea Patients 1 Am J Manag Care. 18 (2012).
- This research shows that patients using PAP also have fewer hospitalizations
that those who do not.
Khayat R, Abraham W, Patt B, Brinkman V, Wannemacher J, Porter K, Jarjoura
D., “Central Sleep Apnea Is a Predictor of Cardiac Readmission in Hospitalized
Patients with Systolic Heart Failure 18 J Card Fail. 534-40 (2012).
- OSA is an independent risk factor associated with cardiac readmissions.
Controlling the disease through the use of home sleep therapy has been
found to reduce hospital readmissions.
Tsolaki V, Pastaka C, Karetsi E, Zygoulis P, Koutsokera A, Gourgoulianis
KI, Kostikas K, “One-year non-invasive ventilation in chronic hypercapnic
COPD: effect on quality of life” 102 Respir Med 904–911 (2008).
- The authors document how home sleep therapy improves patients’ quality