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    How to improve care, hit quality metrics for COPD patients


    Understand COPD admission Trends

    Transitional care management (TCM)—the process of helping patients transition from the hospital back to the community—not only helps prevent readmissions, it allows physicians to get paid for the time they spend identifying any barriers to treatment. 

    That’s because when billing TCM, physicians must meet with patients within seven or 14 days of discharge, depending on the medical complexity of the patient’s condition. Doing so gives physicians the opportunity to identify what may have caused the admission and the barriers that prevent patients from adhering to treatment, she adds. 

    Follow up with patients who cancel their post-discharge appointments, says Lohr. Why did the patient cancel? For example, a lack of transportation sometimes can cause patients to forgo meeting with their physician after a hospitalization. She encourages physicians to build connections with local agencies and other organizations that provide support to patients.

    Regardless of whether they bill TCM, physicians must be able to monitor patients with COPD who frequently go to the emergency department or urgent care, says Brian Boyce, CPC-I, chief executive officer at ionHealthcare LLC, in Richmond, Virginia, a company specializing in risk-adjustment coding and education. Does the patient need additional education? Should they be taking a different medication? Does the patient have comorbidities that must be considered? Physicians need to ask these questions not only to help patients stay healthy but to reduce costs that could ultimately affect their own payments, he adds. 

    Lohr says physicians in independent practice may also want to contact local hospitals to ensure that hospital physicians know how to reach them when a patient presents with a COPD exacerbation. An internist, for example, can shed light on the patient’s symptoms, habits and unique challenges.

    Simple steps can make a significant difference, says Lohr. For example, many hospitals and home health agencies now employ COPD navigators who can help patients stay healthy and out of the hospital. By connecting patients with these individuals, physicians are providing patients with local resources who can answer questions and give support, she adds.

    “You need to be thinking about how to connect across the care continuum,” Lohr says. “If you’re on the hook for outcomes, then it’s better to be proactive.”  

    Lisa Eramo, MA
    Lisa Eramo, MA, is a contributing author for Medical Economics.


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