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Most respiratory professionals agree when it comes to asthma education, it pays to get certified - at least as far as patient care is concerned. But they hope certification eventually will pay off financially too.
Getting the Centers for Medicare & Medicaid Services to assign CPT codes for patient self-management of chronic diseases was the first step toward reimbursement.
"The next part of the process is getting dollar amounts associated with those codes through Medicare and to do that, we need to establish exactly what they're asking for," said Shawn McCormick, BS, RRT, AE-C, past chair of the National Asthma Educator Certification Board.
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| ADVANCE thanks Middlesex Hospital, Middletown, Conn. |
Essentially CMS is asking programs to show that qualified health care professionals are educating patients using a curriculum that meets high quality standards. While asthma educators can prove they are qualified with an AE-C credential, there has not been a formal mechanism to verify a curriculum's credibility until this year.
"I think a national standard for asthma education is going to be imperative," said Karen L. Gregory, MS, APRN-BC, CNS, RRT, AE-C, president of the Association of Asthma Educators.
Two professional organizations are pursuing that goal through different avenues. The American Association of Respiratory Care recently launched its Asthma Self-Management (ASME) certification program, and the Joint Council of Asthma, Allergy, and Immunology is working to publish a standardized asthma education curriculum later this year. Asthma educators hope these steps finally will open the door to much-needed reimbursement dollars.
"We're patient advocates, first and foremost," Gregory said. "But it takes money to get the job done, and reimbursement would allow us more opportunity to better care for our patients with asthma."
Easing the burden
Up until now, asthma programs that deliver education and training for patient self-management have had to substantiate their curriculum on a payer-by-payer basis with documentation to prove they meet national guidelines.
Gregory experienced that struggle firsthand when she co-owned an asthma management clinic years ago. "We knew our program was good because it followed the NAEPP guidelines, but we had no official standard to measure it by at that time," she said.
The AARC hopes the launch of its ASME certification program in February will ease some of those burdens. "We've essentially taken a lot of that headache away by compiling standards that adhere to the Expert Panel Report," said Thomas Kallstrom, RRT, FAARC, chief operating officer of the AARC.
The thorough review process takes about 60 to 90 days to complete, and is open to any asthma disease management program that has accepted patients for at least six months, Kallstrom explained. Certification is awarded for a three-year period.
"Our hope is that this certification provides more marketability and hopefully better reimbursement for programs," said Bill Dubbs, MEd, MHA, RRT, FAARC, director of education and management services for AARC. "This is not something we anticipate Medicare is going to embrace, but we're looking more toward private third-party payers right now."
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