Among the health care community, the 1990s will be remembered as the decade when allied health care professionals (including respiratory care practitioners) were called upon by the payor community, and managed care, in particular, to prove their worth. No longer was it acceptable to simply assume that everyone knew and appreciated the value of health care specialists. In fact, many allied health care practitioners started to feel like a character in a Rodney Dangerfield skit, bemoaning the fact that they “got no respect.” This has been especially true among RCPs, who have had to defend their basic existence and deal with accusations that other allied health care professionals (such as nurses) could simply take over their job function of providing patients with respiratory care. Fortunately, RCPs and their representative associations fought back and now enjoy a relatively safer place within the health care arena. From hospital administrators to large managed care plans, RCPs are looked on more favorably today than in the past, and judging by the results of a recent study, RCPs’ overall value to patient care and their ability to contribute cost-effective treatment are about to increase even more.

Commissioned by the American Association for Respiratory Care (AARC) and conducted by Washington, DC-based Muse & Associates, a study was released in August documenting that death rates for Medicare beneficiaries during the initial skilled nursing facility (SNF) stay for lung disease as being 42% lower for patients who receive treatment by RCPs, compared with those who are not cared for by RCPs. Just as important, the study concluded that cost savings for RCP-treated patients are close to $100 million, based on shorter length of stay (LOS). Patients cared for by RCPs had a 3.6-day shorter LOS. The study results were determined by examination of Health Care Financing Administration (HCFA) data from 1996 for Medicare beneficiaries with lung disorders. While these results are good news for the RCP community, the study is further evidence that utilization of specialists is beneficial to both the health of patients and health care economics. Cutting back on care by specialists is not the answer to reduce overall health care expenditures, and in this particular case, the RCP’s ability to positively impact a lower LOS actually contributed to a major cost savings.

The fact that the study was conducted outside the traditional hospital setting where the majority of RCPs work further supports the stance that RT Magazine has taken since its debut in 1988, that RCPs are well positioned to insert themselves into the alternate care setting, with SNFs being only one of many alternative settings. The respiratory home care market continues to be an ideal setting for RCPs, and as recently predicted by a Wall Street analyst, the respiratory home care market is only going to grow. In a recent Eli’s Home Care Week, analyst Michael Weber with Prudential Vector Healthcare Group in Deerfield, Ill, estimates that the home respiratory care market will experience revenue growth of 7% to 10% over the next 2 years. In addition to home respiratory care, the obstructive sleep apnea market is projected to grow 10% to 15%, and noninvasive positive pressure ventilation and asthma therapy to grow 10%. With this growth comes a need to ensure that these patients are being cared for by RCPs.

Now is the time for RCPs to assist the AARC and other respiratory associations to get the word out that patients, payors, and the overall health care system benefit greatly when respiratory patients are cared for by respiratory specialists. The future of RCPs, in both the hospital and alternate care settings, is bright, and in driving home the message about the value and benefit that RCPs bring to patient care and a sound fiscal health care policy, maybe the next decade will not be so much about survival, but about advancing respiratory care.