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COPD and Asthma Disease Management Programs

The Breathe Better Asthma and COPD programs identify members with Asthma or Chronic Obstructive Pulmonary Disease (COPD) and feature a continuum-based approach that allows interventions to be adapted based on the severity of the patient’s illness.

The goals of the Breathe Better programs are to promote ease of breathing and adequate oxygenation for members with COPD/Asthma through:

• enhanced communication between patients and health care providers;
• more effective use of medications due to increased understanding,
  communication and monitoring;
• improved patient behaviors necessary for successful Asthma/COPD
  management – symptom monitoring, treatment adherence and
  self-management;
• promotion of lifestyle modifications in relation to smoking and other
  healthy choices;
• improved outcomes – quality of life and through early identification
  of symptoms; and
• improved patient and provider satisfaction.

Many asthma and COPD patients have difficulty following the plan of care given to them by their provider. The Breathe Better programs provide enrolled members with a case manager, most often a CCM-certified registered nurse or respiratory therapist, who can be accessed by a multi-disciplinary team working together to treat members with asthma and COPD. Members can contact their case manager when they note a change in their condition or have questions or concerns.

The Breathe Better programs provide patient information and monitoring between office visits. Providers may receive written or telephonic updates of their patients’ progress, including educational areas discussed, current symptoms and if a significant change in symptoms is noted. A program participant may be re-stratified into a higher level of acuity, resulting in more frequent contact from their case manager if their condition warrants.

Providers are eligible for reimbursement upon completion of an enrollment form for each patient who:

• meets program telephonic management criteria; and
• successfully enrolls in the program.

If you would like additional information about the Breathe Better programs or would like to refer a member for enrollment, please call the Preferred Care Breathe Better Enrollment Specialist at (585) 258-8076 or 1-800-933-3920, ext. 8076.

Last updated: August 30, 2007