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Reduce COPD care disparity: Check Rx after discharge
June 30, 2022

This article is for primary care providers and pulmonologists caring for our members

A review of Blue Cross Blue Shield of Massachusetts data found Black and Hispanic members were less likely to get appropriate access to treatments for chronic obstructive pulmonary disease (COPD), including bronchodilator and corticosteroid prescriptions. Prescribing appropriate medications can help control symptoms and prevent inpatient or emergency department (ED) visits.

Your patient may be confused, scared, or unsure after an exacerbation—a brief telehealth check-in with your care team focused on medication adherence may help.

Inequities in COPD

“We are very focused on collaborating with our provider partners to better understand the racial and ethnic inequities that exist for COPD and many other conditions and to support effective solutions to try to close those gaps,” said Dr. Sandhya Rao, Blue Cross’ chief medical officer. “Addressing these longstanding inequities will take strong partnership with members, their doctors, and their communities.”

Read more in Coverage, An empowered approach to COPD.

Follow up is important to prevent further exacerbations

If your patient with COPD has gone to the emergency room or had an inpatient stay due to an exacerbation, follow up with them to ensure they understand how and when to take their medications. When clinically appropriate, you should prescribe the following to patients who’ve had an exacerbation:

  • A systemic corticosteroid, filled within 14 days of discharge AND
  • A bronchodilator, filled within 30 days of discharge

Tips to improve outcomes for your patients with COPD

  • Prioritize population screening to understand exposure in high-risk populations.
  • Help your patient understand preventive measures such as smoking cessation and using well-ventilated areas for cooking and heating, as well as awareness of possible triggers such as high-risk occupations.
  • Ask your patient if they have a barrier to filling the prescription. Many drug manufacturers have coupons available on their websites, and pharmacies have delivery services–often at no cost.
  • Coordinate care with specialists such as pulmonologists. Access to care can be a common barrier because of the lack of resources and local availability.
  • Learn how health literacy can affect your patients. Education on COPD and its risk factors should be culturally sensitive and at the appropriate education level to promote understanding.

Working together to improve quality

Pharmacotherapy Management of COPD Exacerbation (PCE) is a NCQA HEDIS®' measure that looks at members 40 and older who’ve had an inpatient discharge or ED visit due to COPD. We review claims to ensure our members are dispensed corticosteroid and bronchodilator medications after an ED or inpatient discharge.

Resources for members

When members have a complex or chronic health condition like COPD, our Team Blue Care Managers are here to help, at no additional cost. We work with you and your patients to coordinate care and manage treatment plans. If you think a member could benefit from care management, please complete our Patient Referral for Health Management Programs & Services Form and return it to the fax number indicated. Or, call Health Management Programs at 1-800-392-0098, Option 1.

HEDIS®' is a registered trademark of the National Committee for Quality Assurance (NCQA).

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[1] Pleasants, R. A., Riley, I. L., & Mannino, D. M. (2016). Defining and targeting health disparities in chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease, 11, 2475–2496. https://doi.org/10.2147/COPD.S79077
2 Team Blue Care Management is available to our commercial (HMO, PPO, & Indemnity) and Medicare Advantage members. For Federal Employee Program (FEP) Case Management, please call 1-800-689-7219, Option 2
.