Role of RTs expanding in new 02 climate

Respiratory therapists are feeling the greatest impact from the new austere environment for oxygen provision, as efforts to cut costs are changing their roles and workloads, says Vernon Pertelle, president and CEO of StratiHealth, a Los Angeles-based consulting and healthcare administration firm.

For sheer context on healthcare operations, Pertelle has a panoramic view of the continuum. Before founding StratiHealth in 2012, he spent more than two decades in executive positions for Kaiser Permanente, Apria Healthcare, SeQual Technologies and Catholic Health Initiatives. He started StratiHealth because “I am blessed to have an insight into every component of health care from a provider standpoint, health plan and policy perspective, as a clinician and as an administrator. I've had the chance to see the pain points, opportunities and where the gaps are in filling those needs.”

An RN and RT, Pertelle was asked to present his views on respiratory technology at a recent investor and analyst meeting for Goleta, Calif.-based Inogen. Ahead of that presentation, he spoke with HME News about current trends in respiratory therapy and home medical equipment provision.

HME News: How would you characterize the state of oxygen/respiratory therapy provision today?

Vernon Pertelle: Reimbursement cuts are forcing respiratory providers to retool their operations in ways that are more efficient. It has impacted labor the most, so RTs are performing more than just clinical services. There have been some layoffs and organizations that use RTs are assigning them jobs beyond the clinical, including sales, marketing and operations management.

HME: Where are the challenges for the industry?

Pertelle: There are myriad challenges in terms of product development versus clinical services. The whole reason for reimbursement cuts is because policymakers don't believe one is better than the other—it is all viewed as a commodity and when you think about what you pay for, commodities get the short end of the stick. The challenge of providing data hasn't been resolved. Oxygen is a drug just like blood pressure, cardiac or cognitive medications. They all have to be monitored, adjusted and     regulated. 

HME: It's been a few years since Medicare implemented regulations penalizing hospitals for patient readmissions. Do you have a sense of whether this has improved patient care or coordination of services between homecare providers and the  hospital?

Pertelle: I don't think it has made a big difference. Hospitals knew for a long time the penalties were on the horizon. ACOs by and large have the opportunity to impact care in a bigger way over the next year or two as more integration occurs, but what I've seen is that the thinking of old has continued to carry over even though the delivery model has changed. It's still the same focus on reimbursement and coverage. The ACOs that are seeing the benefits are thinking in terms of quality and efficiency.