Pulls the Trigger on COPD in 2015CMS将触发对慢性阻塞性肺疾病2015课件.pptVIP

Role of Nebulized Therapy in COPDDhand R, et al. COPD; Feb 2012 RECOMMENDATION: Many patients, especially elderly patients with COPD, are unable to use their pMDIs and DPIs in an optimal manner. For such patients, nebulizers should be employed on a domiciliary basis. . . Nebulizers are more forgiving to poor inhalation technique, especially poor coordination with pMDIs and the requirement to generate adequate peak inspiratory flows with DPIs. Ease of use; simple technique Addresses inconvenience issue Effective and reliable drug delivery Use not limited by disease severity or mental acuity Device medications covered under Medicare Part B Nebulized Therapy at Home Managing Stable COPD Goals of Therapy Relieve airflow obstruction Improve exercise tolerance Reduce symptoms Improve health status Prevent disease progression Prevent treat exacerbations Reduce risk Reduce mortality Reduced symptoms + Reduced risk = Successful disease management Improving COPD Care OutcomesSummary A new COPD care pathway essential COPD patients will impact hospital’s revenue Patient volume will vary by institution (1-2/month to 6-8/month) Advocate evidence-base care Re-design current workload Allocate resources accordingly Start small; Expand as necessary Appoint, anoint, elect one departmental COPD Guru Let patient volume drive program development Determine risk grade per 2013 GOLD Guidelines Use CAT (or) mMRC Ensure proper controller medications prescribed Recommend follow-up MD appointment within 5-7 days New CMS Payment ModelsSummary Two distinct programs Value-based Purchasing Program (VBP) Bonus payment (or) penalty Based on Core Performance Measures reported for: AMI, CHF, Pneumonia Hospital Readmission Reduction Program (HRRP) Penalty only Based on historic readmission rates for: AMI, CHF, Pneumonia Additional conditions to be added in FY 2015 COPD for HRRP COPD Core Performance Measures coming for VBP? Domain of Likely COPD Perf