You may have heard about Medicare’s increasing interest in measuring the benefits and outcomes of services that Medicare pays for. This represents a fundamental shift away from paying for a service that is provided regardless of whether that "procedure" is effective or not. All areas of health care are being held accountable to show that a patient is better off after a service or treatment than he/she was before that intervention. Services that have been demonstrated by solid research to be effective are incorporated into professional practice guidelines to help practitioners remember to utilize those practices. One well-known example of this "standard of care" is an aspirin a day after a heart attack (unless there is a medical reason not to prescribe this drug to a particular patient).
Pulmonary rehabilitation is another example of an evidence-based service. In fact, practice guidelines for pulmonary rehab have given both exercise training and improvement of dyspnea symptoms the highest grade of 1A. This grade indicates that science has shown significant benefits and outcomes for both these measurements in patients who receive pulmonary rehab compared to similar patients who don’t participate in a pulmonary rehab program.
You probably know that already. You may not realize that the outcome of quality of life, referred to as QOL, after pulmonary rehabilitation also has a recommendation of 1A. This means pulmonary rehab has been shown to improve quality of life significantly. We measure quality of life with a written questionnaire before and after a person participates in a pulmonary rehab program. In fact, studies have shown that this improvement is sustained up to two years after a pulmonary rehabilitation course.
If you’ve participated in a pulmonary rehab program, you probably aren’t surprised by this finding. When it comes down to it, most of us agree that we aren’t aspiring to stand on that Olympic medal platform-we want to feel better and experience some quality in our daily activities.
We all recognize that there’s more to life than how many feet you can walk in 6 minutes. The mental preparedness you bring to your day is equally important. I hope you share my optimism that our healthcare payers, both Medicare and private insurers, are finally beginning to get the connection and acknowledge there is value in those “harder to measure” outcomes. NHOPA is committed to continuing to educate our payers on this fact of life.
Information on this page is for reference and educational purposes only. For more information talk to your doctor or primary care provider.
Page last updated: November 26, 2018
- Medicare.gov. What Medicare Covers. https://www.medicare.gov/what-medicare-covers
- NCBI. Aspirin Use Is Associated with an Improved Long-term Survival in an Unselected Population Presenting with Unstable Angina. Published: September 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785089/
- NCBI. Pulmonary rehabilitation: summary of an evidence-based guideline. https://www.ncbi.nlm.nih.gov/pubmed/18718040
- Medscape. Pulmonary Rehabilitation. Last updated: August 29, 2018. https://emedicine.medscape.com/article/319885-overview
- Oxford Academic. Quality of Life After Pulmonary Rehabilitation: Assessing Change Using Quantitative and Qualitative Methods. Published: October 1, 2000. https://academic.oup.com/ptj/article/80/10/986/2857768